Chapter 9: Rheumatology and Orthopedics: Musculoskeletal System

The chapter details crystal-induced arthropathies including gout, which predominantly affects the first metatarsophalangeal joint through monosodium urate precipitation, and pseudogout, involving calcium pyrophosphate dihydrate deposition typically in larger joints. Systemic lupus erythematosus receives attention as a multisystem autoimmune condition with diverse clinical presentations ranging from cutaneous manifestations to renal and hematologic involvement. Fibromyalgia is presented as a central sensitization syndrome characterized by widespread pain amplification and associated constitutional symptoms. The chapter then transitions to primary bone and joint disorders, emphasizing osteoporosis as a metabolic condition reducing skeletal density and fracture resistance, with discussion of diagnostic imaging and pharmacologic interventions. Tendinitis, bursitis, and osteomyelitis represent inflammatory and infectious pathologies requiring differentiated therapeutic approaches. Fracture management is explored across various anatomic presentations and age groups, including pediatric variants with distinct healing characteristics. The regional sections systematically address upper extremity conditions including rotator cuff pathology, compressive neuropathies, and common fracture patterns; spinal disorders encompassing degenerative disc disease, neural compression syndromes, and structural deformities; and lower extremity pathology including hip, knee, and foot disorders. Throughout the chapter, clinical presentation patterns, appropriate diagnostic modalities, and evidence-based treatment algorithms are integrated to prepare learners for clinical application and examination performance.