Soft-Tissue Rheumatism: Diagnosis and Management

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Soft-tissue rheumatism often is a challenging disorder for the primary care physicians. The patient's symptoms often are vague, and the physical examination and laboratory testing often do not give comforting confirmatory findings. This issue reviews common conditions that afflict many of our patients and that, although often not serious, cause significant distress and morbidity. With the proper history and attention to presenting features, effective and professionally rewarding treatments are available.

The article is outlined principally by the typically affected body part—shoulder to foot— and the PCP will find this organization helpful in the practical workup and treatment of these common conditions.

A non-medical family member from a distant state recently called me asking for my advice regarding his increasingly severe foot pain. He works while on his feet all day as a printer and described pain that was particularly bad in the morning when he first gets out of bed. My immediate impression was plantar fasciitis —which he promptly wrote down—and will take to his doctor for confirmation and treatment. I am waiting patiently to see if my telemedicine diagnosis was correct and if I will garner his unending praise due to my diagnostic acumen.

—The Editor

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