General Musculoskeletal Conditions
Musculoskeletal problems are very common. The vast majority of musculoskeletal problems do not need an operation so for almost all people, a visit to a musculoskeletal doctor, physiotherapist or Rheumatologist first, is wisest. Rheumatologists have the widest knowledge of musculoskeletal conditions compared with other specialists, so are useful people to see to obtain a diagnosis. Rheumatologists will have a broad view of the right tests to do (imaging and lab tests) to make a diagnosis then, because they work in multidisciplinary teams, automatically link in, as necessary, with others (physiotherapists, surgeons, podiatrists and other therapists) so that the right treatment for a person’s problem is undertaken quickly by the right person.
Below are lists of common (‘body-regional’) musculoskeletal conditions that a Rheumatologist, such as Dr Clunie, typically sees in adult patients:
Neck: osteoarthritis, intervertebral disc disease, crowned dens syndrome (CPP disease causing pain right at the top of the neck), spondyloarthritis, nerve root entrapment (‘radiculopathy’);
Shoulder and upper arm: arthritis of acromioclavicular joint, frozen shoulder, rotator cuff tendonitis/bursitis, enthesitis associated with spondyloarthritis, pseudogout of shoulder joint, referred pain from the neck, polymyalgia rheumatic;
Anterior chest wall: psoriatic arthritis (enthesitis of intercostal muscles), SAPHO Syndrome, costochondritis;
Back: see under ‘Back pain’ elsewhere on this website;
Elbow: arthritis; tennis elbow (?enthesitis), golfer’s elbow (?enthesitis), olecranon bursitis (?gout);
Wrist and forearm: arthritis (rheumatoid arthritis, psoriatic arthritis, CPP disease), tendonitis (e.g. DeQuervain’s tenosynovitis), ‘RSI’ (lay term for forearm pain, is not a disease and is usually due to one of a number of different conditions!), radicular pain (referred pain from trapped/irritated nerve in the neck);
Hand: finger/thumb joint arthritis, tendonitis, dactylitis, carpal tunnel syndrome (treated with splinting and cortisone injection often first before referral for an operation), ulnar nerve symptoms from nerve irritation at elbow or wrist;
Hip and pelvis: trochanteric pain syndrome (side of the hip, often due to gluteus medius tendon insertional enthesitis), symphysis pubis pain (central groin pains), arthritis of the hip joint (any type), sacroiliitis (posterior pelvis/buttock pains), ischial enthesitis, bone conditions (stress fracture, Paget’s disease);
Knee: arthritis (all types!), patella tendon problems (?enthesitis, fat-pad syndrome, patellofemoral joint osteoarthritis), enthesitis (many sites around the knee - common in spondyloarthritis and psoriatic arthritis), gout and pseudogout (often causes fluid to accumulate – rheumatologists can take fluid out, send it for analysis and inject cortisone if needed);
Ankle and foot: arthritis (all types!), tendonitis, enthesitis, ligament and plantar fascia problems (e.g. plantar fasciitis, which is commonly associated with spondyloarthritis – see information elsewhere on this website), tarsal tunnel syndrome, referred pain from a trapped nerve in the back (sciatica), interdigital neuroma pains (between the toes).