Common painful syndromes [antikvár]

Painful localised rheumatological syndromes Who amongst us has not, on one or more occasions, suffered from a sore neck, sore foot, or low back pain? These types of complaint are the bread and butter of the generál practitioner. Textbooks on rheumatology, and teaching on this subject in generál, are usually arranged under disease headings: osteoarthrosis, rheumatoid arthritis, etc. A concise guide for interpreting the symptoms - mostly pain - according to the region of the body involved therefore serves to fill a gap. In the patient who complains of pains in - the neck and upper limbs, - in the back, - or in the lower limbs: What does one think of? How does one reach a useful diagnosis? What therapeutic approach should one adopt? The aim of this book is not to cover all the syndromes of the musculoskeletal system, but to deal succinctly with the most frequent or most often missed disorders of a localised nature. Post-traumatic lesions and disorders in children will not be discussed. In its early stages a systemic rheumatic disease may affect only one joint or one serous bursa. These classic entities thus enter into the differential diagnosis of any localised syndrome. Any joint or serous bursa can be infected, and one should therefore never forget to exclude the possibility of sepsis by culturing synovial fluid aspirated from joints or bursae. A bone disorder, e.g. osteochondritis dissecans, aseptic necrosis, or an osteoid osteoma, may alsó be the underlying cause of a localised symptom. All these conditions will not be mentioned in connection with differential diagnosis unless they present a predominant localisation or display more specific clinical signs at the site involved. One should never forget the possibility that the underlying cause may be: - an infection - a systemic disorder (commencing in a localised fashion) - a bone disease - atumour. In the presence of atypical persisting pains, or if treatment given for a reasonable period of time still proves ineffective, the diagnosis should be reviewed. At this time a specialist's opinion may be helpful or at least reassuring.