At least 10% of patients with clinical presentations to primary care physicians have musculoskeletal complaints, and a 1990 Ontario (Canada) study found these disorders were the most common reasons for consulting a health care professional. These facts contrast sharply with the reality that many physicians receive little or no instruction on arthritis, back disease or osteoporosis in medical school. Given that almost 50% of elderly people have symptomatic disease, 25% of these people are disabled due to their conditions and Canada's population is aging, there has likely never been a more appropriate time for an update on the diagnosis and management of rheumatologic disease.
This issue of the Canadian Medical Association Journal presents the introduction and the first instalment in a series on rheumatology, a medical field that has changed dramatically over the last decade and continues to progress at an accelerating pace. The first article in the series highlights several patients who present to clinicians with various symptoms: low back pain, swelling in the joints, stiffness and other indicators. The article outlines the 5 basic steps that will help a physician arrive at a rheumatologic diagnosis precise enough to serve as the basis for further investigation and treatment.
Rheumatology: introduction to the series -- Dr. John Esdaile
Rheumatology: 1. Is it arthritis? -- Dr. Stephanie Ensworth