{"id":9059,"date":"2021-12-11T19:42:43","date_gmt":"2021-12-11T17:42:43","guid":{"rendered":"https:\/\/meddists.com\/learn\/clinical\/rheumatology\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\/"},"modified":"2022-04-23T18:28:56","modified_gmt":"2022-04-23T16:28:56","slug":"soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/rheumatology\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\/","title":{"rendered":"Soft tissue (non-articular) rheumatism: bursitis, tendinitis, fibromyalgia"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Soft tissue rheumatism is a group of degenerative or inflammatory diseases affecting the subcutaneous connective tissue, muscles, ligaments, tendons, bursae, and associated tissues. The conditions can be acute or chronic.<\/p>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Bursitis<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">Bursae are sac-like structures filled with synovial fluid resembling water balloons, reducing friction between tendons and adjacent joint capsules and bony prominences during movement.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bursitis is the inflammation of these bursae, and it may be acute or chronic, affecting superficial, or deep bursae.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><span style=\"color: initial;\">Presents with pain and swelling.<\/span><\/li><li>Most commonly affects the bursae around the shoulder, elbow (olecranon), hip (trochanter) and knee.<\/li><li>Acute cases are typically idiopathic or associated with trauma or overuse, with chronic cases being due to repetitive trauma, arthritis (RA, OA, crystal-induced) and chronic infections.<\/li><li>Baker&#8217;s cyst is a common manifestation of bursitis of the knee, seen in rheumatoid arthritis.<\/li><li><strong>Diagnosis<\/strong>. Radiological imaging and aspiration of bursal fluid with culture.<\/li><li><strong>Treatment<\/strong><ul><li>RICE (Rest, Ice, Compress, Elevate)<\/li><li>Treat the underlying condition<\/li><li>NSAIDs<\/li><li>Corticosteroid injections<\/li><li>Antibiotics if culture returns positive<\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Tendinitis<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">Tendinitis is a condition in which the tendons become inflamed. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Presents with pain, and sometimes swelling.<\/li><li>Mostly affects the tendons of the rotatory cuff muscles, biceps, tendons of the forearms and hands, and Achilles tendon.<\/li><li>In the case of chronic tendinitis, scarring and calcification may occur.<\/li><li>Tendovaginitis (tenovaginitis\/tenosynovitis) is tendinitis together with the inflammation of the tendon sheath.<\/li><li><strong>Etiology<\/strong>. The etiology is unknown, but is related to repetitive microtrauma, overuse, and trauma.<\/li><li><strong>Diagnosis<\/strong>. The diagnosis is clinical, supported by radiological imaging.<\/li><li><strong>Treatment<\/strong><ul><li>RICE<\/li><\/ul><ul><li>NSAIDs<\/li><li>Corticosteroid injection into the tendon sheath (<strong>not <\/strong>the tendon itself!)<\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Forms<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<ul class=\"wp-block-list\"><li><strong>De Quervain tenosynovitis<\/strong>. Inflammation in the tendons of the thumb at the styloid process of the radius, causing severe pain and swelling, typically caused by excessive usage of the thumb as in writing.<ul><li><strong>Finkelstein test<\/strong> involves abduction of the thumb into the palm, wrapping of the fingers around it in a shape of a fist, and tilting the fist towards the ulna. The test is positive if painful.<\/li><\/ul><\/li><li><strong>Tennis elbow<\/strong>. Inflammation of the extensor tendons (lateral epicondilitis).<\/li><li><strong>Golfer&#8217;s elbow<\/strong>. Inflammation of the flexor tendons (medial epicondilits).<\/li><li><strong>Trigger finger<\/strong>. Inflammation of the digital flexor with fibrosis that leaves a &#8220;knot&#8221;, requiring extra tension to pass the knot through the tendon sheath, simulating a &#8220;trigger&#8221;. Treated surgically.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Fibromyalgia<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<p class=\"wp-block-paragraph\">Fibromyalgia is a chronic condition presenting with generalized muscle and nearby tissue pain, and tenderness.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Generalized symptoms that may include fatigue, sleep disturbances, and headaches, depression, among others.<\/li><li><strong>Etiology<\/strong>. The etiology is unknown; current theory suggests that it is a disorder of pain sensitivity.<ul><li>Lack of sleep and emotional stress may contribute to the development of the disease.<\/li><\/ul><\/li><li><strong>Epidemiology<\/strong>. Significantly more common in females.<\/li><li><strong>Diagnosis<\/strong>. Clinical presentation along with normal tests may suggest fibromyalgia.<ul><li>According to ACR (American College of Rheumatology) criteria, the presence of 11 out of 18 tender points along with exclusion of other diseases.<\/li><li>CK, ESR, and CRP, EMG tests should be evaluated to exclude myopathies.<\/li><li>Histological samples and laboratory tests are normal.<\/li><\/ul><\/li><li><strong>Management<\/strong>. <ul><li>Stress management<\/li><\/ul><ul><li>Physiotherapy<\/li><li>Analgesics<\/li><li>TCA\/SSRI\/gabapentin<\/li><li>Local lidocaine injections<\/li><\/ul><\/li><\/ul>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Bursitis<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Tendinitis<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Forms<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Fibromyalgia<\/h3><\/div>","protected":false},"excerpt":{"rendered":"<p>Soft tissue rheumatism is a group of degenerative or inflammatory diseases affecting the subcutaneous connective tissue, muscles, ligaments, tendons, bursae, and associated tissues. The conditions can be acute or chronic. Bursitis Bursae are sac-like structures filled with synovial fluid resembling water balloons, reducing friction between tendons and adjacent joint capsules and bony prominences during movement. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":8424,"menu_order":10,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-9059","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Soft tissue (non-articular) rheumatism: bursitis, tendinitis, fibromyalgia &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/rheumatology\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/rheumatology\\\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/rheumatology\\\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\\\/\",\"name\":\"Soft tissue (non-articular) rheumatism: bursitis, tendinitis, fibromyalgia &#8211; Meddists\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/#website\"},\"datePublished\":\"2021-12-11T17:42:43+00:00\",\"dateModified\":\"2022-04-23T16:28:56+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/rheumatology\\\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/rheumatology\\\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/rheumatology\\\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\\\/\\\/meddists.com\\\/learn\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Clinical\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Internal medicine\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Rheumatology\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/rheumatology\\\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Soft tissue (non-articular) rheumatism: bursitis, tendinitis, fibromyalgia\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/#website\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/\",\"name\":\"Meddists\",\"description\":\"Let&#039;s Get Studying\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/meddists.com\\\/learn\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Soft tissue (non-articular) rheumatism: bursitis, tendinitis, fibromyalgia &#8211; Meddists","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/rheumatology\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\/","twitter_misc":{"Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/rheumatology\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\/","url":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/rheumatology\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\/","name":"Soft tissue (non-articular) rheumatism: bursitis, tendinitis, fibromyalgia &#8211; Meddists","isPartOf":{"@id":"https:\/\/meddists.com\/learn\/#website"},"datePublished":"2021-12-11T17:42:43+00:00","dateModified":"2022-04-23T16:28:56+00:00","breadcrumb":{"@id":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/rheumatology\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/rheumatology\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/rheumatology\/soft-tissue-non-articular-rheumatism-bursitis-tendinitis-fibromyalgia\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/meddists.com\/learn\/"},{"@type":"ListItem","position":2,"name":"Clinical","item":"https:\/\/meddists.com\/learn\/clinical\/"},{"@type":"ListItem","position":3,"name":"Internal medicine","item":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/"},{"@type":"ListItem","position":4,"name":"Rheumatology","item":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/rheumatology\/"},{"@type":"ListItem","position":5,"name":"Soft tissue (non-articular) rheumatism: bursitis, tendinitis, fibromyalgia"}]},{"@type":"WebSite","@id":"https:\/\/meddists.com\/learn\/#website","url":"https:\/\/meddists.com\/learn\/","name":"Meddists","description":"Let&#039;s Get Studying","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/meddists.com\/learn\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/9059","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/comments?post=9059"}],"version-history":[{"count":6,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/9059\/revisions"}],"predecessor-version":[{"id":10758,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/9059\/revisions\/10758"}],"up":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/8424"}],"wp:attachment":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/media?parent=9059"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}