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(BQ) Part 2 book "Harrison's rheumatology" presents the following contents: Disorders of the joints and adjacent tissues, laboratory values of clinical importance, review and self-assessment. Invite you to consult. | SECTION III DISORDERS OF THE JOINTS AND ADJACENT TISSUES CHAPTER 18 APPROACH TO ARTICULAR AND MUSCULOSKELETAL DISORDERS John J. Cush Peter E. Lipsky Musculoskeletal complaints account for 315 million outpatient visits per year and nearly 20 of all outpatient visits in the United States. The Centers for Disease Control and Prevention estimate that 22 46 million of the U.S. population has physician-diagnosed arthritis and 19 million have significant functional limitation. While many patients will have self-limited conditions requiring minimal evaluation and only symptomatic therapy and reassurance specific musculoskeletal presentations or their persistence may herald a more serious condition that requires further evaluation or laboratory testing to establish a diagnosis. The goal of the musculoskeletal evaluation is to formulate a differential diagnosis that leads to an accurate diagnosis and timely therapy while avoiding excessive diagnostic testing and unnecessary treatment Table 18-1 . There are several urgent conditions that must be diagnosed promptly to avoid significant morbid or mortal sequelae. These red flag diagnoses include septic arthritis acute crystal-induced arthritis e.g. gout and fracture. Each may be TABLE 18-1 EVALUATION OF PATIENTS WITH MUSCULOSKELETAL COMPLAINTS Goals Accurate diagnosis Timely provision of therapy Avoidance of unnecessary diagnostic testing Approach Anatomic localization of complaint articular vs. nonarticular Determination of the nature of the pathologic process inflammatory vs. noninflammatory Determination of the extent of involvement monarticular polyarticular focal widespread Determination of chronology acute vs. chronic Consider the most common disorders first Formulation of a differential diagnosis suspected by its acute onset and monarticular or focal musculoskeletal pain see later in chapter . Individuals with musculoskeletal complaints should be evaluated with a thorough history a comprehensive physical and .