Overview of soft tissue rheumatic disorders
- Irving Kushner, MD
Irving Kushner, MD
- Professor Emeritus
- Case Western Reserve University
Soft tissue rheumatic disorders refer to nonsystemic, focal pathologic syndromes involving the periarticular tissues, including muscle, tendon, ligament, fascia, aponeurosis, retinaculum, bursa, and subcutaneous tissue. These disorders are extremely common. The archaic term "rheumatism" is sometimes used to refer to these manifestations.
Although soft tissue rheumatic disorders refer to nonarticular pain, patients often attribute their symptoms to nearby joints. Thus, when patients complain of hip pain, the cause is often not pain in the joint itself, but rather in the "hip region": the groin, buttock, upper lateral thigh, greater trochanteric area, and iliac crest. Similarly, complaints of elbow, wrist, knee, and shoulder pain frequently mean pain in the general region of those joints, and may reflect soft tissue lesions such as epicondylitis, tenosynovitis, and bursitis.
Soft tissue disorders may be divided into several broad categories and include:
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- SPECIFIC SYNDROMES
- Structural disorders
- Neurovascular entrapment
- Complex regional pain syndromes
- Myofascial pain syndrome
- Generalized pain disorders
- GENERAL INITIAL APPROACH
- Exclude systemic disease
- Eliminate aggravating factors
- Explain the illness
- Explain self-help strategies
- Pain relief
- Explain prognosis
- SUMMARY AND RECOMMENDATIONS