An Overview of the Musculoskeletal System

Excerpt

There are five cardinal symptoms of musculoskeletal disease (Table 158.1): pain, swelling, erythema (redness), warmth, and stiffness. Pain is the major symptom. "Aching" or "throbbing" are the words most often used by patients to describe musculoskeletal pain, in contrast to "crushing," "boring," or "sharp" with reference to ischemic, visceral, or neuropathic pain. Pain should also be characterized as to location, positional relationships, frequency, duration, and precipitating or relieving factors. The historical identification of swelling, erythema, and warmth is of great importance. Stiffness is a symptom unique to the musculoskeletal system. The predilection of stiffness for certain times of the day (e.g., upon awakening), its duration and location are points of considerable historical importance. The pattern of involvement should be ascertained: anatomic area, self-limited or progressive, migratory or stationary, effect of treatment modalities. The presence and degree of weakness or other neurologic deficits should be ascertained.