Basic Approach to the Rheumatic Diseases

Basic Approach to the Rheumatic Diseases is a topic covered in the Washington Manual of Medical Therapeutics.

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Arthritis is any disease process affecting a joint or joints, causing pain, swelling, and stiffness. Arthritis can be categorized as inflammatory or noninflammatory depending on the pattern of joint involvement and the evidence of inflammatory findings on joint exam. Periarthritis, which mimics arthritis, involves the soft tissues surrounding the joint like tendons and bursal structures. Periarthritis needs to be differentiated from true arthritis. Pain from a true articular process is usually present in all directions of motion and throughout the range of motion of a particular joint, whereas pain from a periarticular process is usually evident at a single point or direction in the range of motion. In periarthritis, pain often is elicited by palpation over a specific area corresponding to a tendon, ligament, or bursa. In addition, pain occurs primarily with active movement in periarthritis, while it can occur with active and passive movements in inflammatory arthritis.

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