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Definition: musculoskeletal disorder from Cambridge Dictionary of Human Biology and Evolution

Disease or syndrome attributed to abnormal formation of bones, muscles, ligaments, tendons, and/or other connective tissue; common examples are muscular dystrophy, osteoarthritis, and osteoporosis.


Summary Article: Musculoskeletal Diseases
from Green Health: An A-to-Z Guide

The musculoskeletal system consists of bones, muscles, ligaments, tendons, joints, cartilage, and other connective tissues. These components all work together to provide form, stability, and movement to the human body. Diseases of the musculoskeletal system may result in the inability to walk, sit, or even breathe, and are generally accompanied by pain, as well as limitations in physical functioning and fatigue. The functional and social limitations associated with musculoskeletal diseases often have emotional consequences as well.

There are many musculoskeletal diseases that require clinical care by a physician or other healthcare professional. Some of the more common musculoskeletal diseases are listed below with a brief description of each for general information, bearing in mind that a diagnosis should always be made in person by a physician or healthcare professional. This entry provides a brief overview of many musculoskeletal diseases, from those that have high impact on functional health to those with low impact.

Repetitive strain injury refers to a range of conditions caused by repetitious movements and force. This can result in functional limitations in the hand, elbow, and shoulder, as well as the health state of chronic back pain. Typically, patients present with weakness and lack of endurance as well as worsening pain with activity.

Osteoarthritis is characterized by the breakdown of cartilage in a joint. Symptoms may include joint pain, tenderness, stiffness, inflammation, creaking, and locking of joints. The patient presents with pain upon weight bearing, including standing and walking, and pain worsens throughout the day as the joints are used. Due to decreased movement because of the pain, regional muscles may atrophy and ligaments may become more lax. In osteoarthritis, a variety of factors may initiate the process leading to loss of cartilage, such as hereditary, developmental, metabolic, and mechanical.

Rheumatoid arthritis is a chronic systemic inflammatory disorder that may affect tissues and organs, but principally attacks the joints, producing an inflammatory synovial membrane, which lines joints and tendon sheaths. Joints become swollen, tender, and warm, and stiffness limits their movement. Rheumatoid arthritis typically manifests with signs of inflammation, and stiffness in the early morning upon waking or following prolonged inactivity. Gentle movements may relieve symptoms in early stages of the disease. As the disease progresses, the inflammatory activity leads to tendon tethering and erosion and destruction of joint surface. This impairs range of movement and leads to deformity.

Systemic lupus erythematosus is a chronic autoimmune connective tissue disease that can affect any part of the body, resulting in inflammation and tissue damage. While systemic lupus erythematosus affects the heart, kidneys, lungs, and other aspects of the human body, the most commonly sought for medical attention is for joint pain. Usually the small joints of the hand and wrist are affected, although all joints are at risk, and lupus arthritis is less disabling and usually does not cause severe destruction of the joints, as seen in other forms of arthritis. Being that systemic lupus erythematosus is a chronic disease with no known cure, the treatment is usually symptomatic, usually preventing flare-ups and reducing their severity.

Fibromyalgia is a chronic condition of the soft tissues characterized by widespread pain. Other core symptoms are debilitating fatigue, sleep disturbance, and joint stiffness. There is no recognized cure for fibromyalgia, but some prescription treatments have been shown to be effective in reducing symptoms. However, fibromyalgia is a controversial diagnosis. Many members of the medical community consider it a nondisease because of a lack of abnormalities on physical examination and the absence of objective diagnostic tests.

Osteoporosis is a disease of bone that leads to an increased risk of fracture. In osteoporosis, the bone mineral density is reduced, and the amount and variety of noncollagenous proteins in bone is altered. The underlying mechanism in all cases of osteoporosis is an imbalance between bone reabsorption and bone formation. Osteoporosis itself has no specific symptoms; its main consequence is the increased risk of bone fractures. Osteoportic fractures are those that occur in situations where healthy people would not normally break a bone. These types of fragility fractures occur in the vertebral column, rib, hip, and wrist. Treatment is usually prescribed with medication, exercise, calcium, and vitamin D.

Bursitis is the inflammation of one of more bursae of synovial fluid in the body. The bursae rest at points where internal functionaries, such as muscles and tendons, slide across bone. Healthy bursae create smooth, painless movement. Movement with bursitis is difficult and painful. Repetitive movement and excessive pressure on the joints typically cause it. Symptoms of bursitis may vary from local joint pain and stiffness to burning pain that surrounds the joint around the inflamed bursa. In this condition, pain is usually worse during and following activity. Bursitis that is not infected is treated with rest, ice compresses, anti-inflammatory drugs, and pain medication.

Cherubism is a rare genetic disorder that causes prominence in the lower portion of the face. Patients with this symptom present with a loss of bone in the mandible, which the body replaces with excessive amounts of fibrous tissue. In most cases, the condition fades as the child grows. This also causes premature loss of primary teeth. The genetic mutation associated with cherubism is said to be autosomal dominant.

Osteogenesis imperfecta is an autosomal-dominant genetic bone disorder. People with osteogenesis imperfecta are born with defective connective tissue or without the ability to make it. The bone is altered in this disease, causing brittleness and loose joints. There are types I to VIII, ranging from mild to severe. All share bones that fracture easily. At the time of this writing, there is no cure for osteogenesis imperfecta.

Gout is a disease hallmarked by elevated levels of uric acid in the bloodstream. In this condition, crystals of uric acid are deposited on the articular cartilage of joints, tendons, and surrounding tissues. Excruciating, sudden, unexpected burning pain, as well as redness, swelling, warmth, and stiffness in the affected joint characterize gout. Hyperuricemia is a common feature of gout; however, gout can occur without hyperuricemia. Ultrasound imaging is helpful in diagnosis of gout. Treatment for gout has three main objectives: to lower serum uric acid, to prevent acute attacks, and to manage the symptoms of acute attacks when they occur.

Chondrocalcinosis is a rheumatologic disorder with varied clinical presentations due to the precipitation of calcium pyrophosphate dihydrate crystals in the connective tissues. Patients usually present with inflammation of one or more joints; this often results in pain in the affected joints. Radiography plays a large role in the diagnosis of chondrocalcinosis.

Septic arthritis is the invasion of a joint by an infectious agent, which produces arthritis. Septic arthritis should be considered whenever one is assessing a patient with joint pain. Usually only one joint is affected. The diagnosis can be difficult because there is no test available to completely rule out the possibility. Diagnosis is done by aspiration of fluid from the joint. Treatment is usually done with intravenous antibiotics and aspiration of the joint to dryness.

Juvenile idiopathic arthritis (JIA) is the most common form of persistent arthritis in children. Juvenile idiopathic arthritis differs significantly from arthritis commonly seen in adults and other types of arthritis that can present in childhood, which are chronic conditions. Symptoms of juvenile idiopathic arthritis are nonspecific initially and include lethargy, reduced physical activity, and poor appetite. The first manifestation may be limping. The main symptom is persistent swelling of the affected joint, which commonly includes the knee, ankle, wrist, and small joints of the hands and feet. Pain is also an important symptom; however, young children may not be able to communicate the pain directly. Other effects are joint contracture and joint damage. There are three kinds of juvenile idiopathic arthritis: oligoarticular, polyarticular, and systemic. Oligoarticular JIA affects four or fewer joints. Polyarticular JIA affects five or more joints. Arthritis, fever, and a pink rash characterize systemic JIA.

Polymyositis is a type of chronic inflammatory myopathy. Polymyositis is usually evident in adulthood, presenting with bilateral muscle weakness. It is mostly noted in the upper legs due to early fatigue while walking, being unable to rise from a seated position without help, and inability to raise arms above head. There is a loss of muscle mass, particularly in the shoulder and pelvic girdle. Thickening of the skin on the fingers and hands is a frequent feature. The cause of polymyositis is unknown, but appears to be related to autoimmune factors, genetics, and in rare cases is known to be infectious. Typically, patients are treated with high-dose steroids; unresponsive patients may be placed on immunosuppressive medication.

Systemic scleroderma is a systemic connective tissue disease. The most visible symptoms are in the skin. Scleroderma causes hardening and scarring, and the skin may appear red and scaly. In regard to musculoskeletal, the first joint symptoms that patients with systemic scleroderma have are nonspecific joint pain. This can lead to arthritis or cause discomfort in tendons or muscles. Calcinosis or skin thickening may restrict mobility of the joints, especially of the small joints in the hand. There is no clear cause for systemic sclerosis. Genetic predisposition appears to be limited. There is no cure for systemic scleroderma; however, there is treatment for the some of the symptoms.

Osteomalacia is a disease in which there is a defect in the bone building process of the bones. The disease is commonly caused by a deficiency in vitamin D, which is obtained through diet and sunlight exposure. Patients typically have a waddling gait as well as pain and aches beginning in the lumbar region and spreading symmetrically. Body pains, muscle weakness, fatigue, and fragility of the bones, also referred to as softening of the bones, are also signs of this disease. Osteomalacia in children is referred to as Rickets.

Osteomyelitis is the inflammation of the bone and bone marrow, caused by an infection. In children, long bones are usually affected. In adults, pelvis and vertebrae are most commonly affected. Osteomyelitis often requires prolonged antibiotic treatment. It may also require surgical debridement and severe cases may lead to the loss of a limb. Diagnosis is based on radiological results and a culture of material taken from the bone biopsy to identify the specific pathogen.

Tietze's syndrome is the benign inflammation of one or more of the costal cartilages. Patients present with acute pain in the chest, along with tenderness and some swelling of the cartilages affected. Pain is often exacerbated with respiration. The condition is usually benign and resolves in 12 weeks; however, it can be a chronic condition. It is common for some patients to mistake the pain for that of a myocardial infarction. Tietze's syndrome does not progress to cause harm to any organs.

Avascular necrosis is a disease resulting from the temporary or permanent loss of the blood supply to an area of bone. Without blood, the bone tissue dies and the bone collapses. If avascular necrosis involves the bones of a joint, it often leads to destruction of the joint articular surfaces. It primarily affects bones of the hip, knee, and shoulder. MRI and bone scintigraphy are the best choices for diagnosis because in early stages, x-rays appear normal. Total joint replacements are common, especially in the hip. Other treatment methods include core decompression and free vascular fibular graft.

Conclusion

Because many other body systems including nervous, vascular, and integumentary systems are interrelated, disorders of one of these systems may also affect the musculoskeletal system and complicate the diagnosis of the disorder's origin. Diseases of the musculoskeletal system mostly encompass functional disorders. The severity of the problem determines the level of impairment. The most common musculoskeletal diseases are articular, pertaining to joints. Disorders of muscles from another body system can display irregularities such as impairment of ocular motion and control, respiratory dysfunction and bladder malfunction. Musculoskeletal diseases have their own origins, however they sometimes are signs and symptoms of other disease: due to that fact, it is always important to check with a physician or other healthcare professional about any disease and treatment options.

See Also:

Antibiotics, Cardiovascular Diseases, Degenerative Diseases, Immune System Diseases, Supplements

Further Readings
  • Dequeker, Jan. Medical Management of Rheumatic Musculoskeletal and Connective Tissue Diseases. New York: Informa Health Care, 1997.
  • Reilly, Thomas. Musculoskeletal Disorders in Health-Related Occupations. Amsterdam: IOS Press, 2002.
  • Schulthess, Von; Konrad, Gustav; and Christoph, L. Zollikofer. Musculoskeletal Diseases: Diagnostic Imaging and Interventional Techniques. New York: Springer, 2005.
  • Guimaraes, Alessandra
    Copyright © 2011 by SAGE Publications, Inc.

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