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22 - Musculo-skeletal disorders

from Part III - Working with specific units

Published online by Cambridge University Press:  10 December 2009

By
Chris Dickens  and
Graham Ash
Edited by
Geoffrey Lloyd  and
Elspeth Guthrie
Geoffrey Lloyd
Affiliation:
Priory Hospital, London
Elspeth Guthrie
Affiliation:
University of Manchester
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Summary

Introduction

The term musculo-skeletal disorders describes a broad range of problems, with varying aetiologies and different natural histories, that are seen and treated in diverse treatment settings. These disorders have in common symptoms (with or without signs) in the muscles, skeleton or connective tissues, with associated functional disability.

It is beyond the scope of this chapter to describe all of the individual musculo-skeletal disorders along with their accompanying psychological/psychiatric features. Instead we have selected the four conditions that best represent the conditions within this group: rheumatoid arthritis, fibromyalgia, osteoarthritis and back pain. By discussing the features of these disorders we have covered the most common, and the most widely studied of the musculo-skeletal disorders.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disorder of unknown aetiology affecting approximately 0.8% of the population, with women being affected three times more often than men. The brunt of this disorder falls on articular and periarticular tissues, resulting in a peripheral symmetrical inflammatory arthropathy. Destruction of joint cartilage and bony erosions can occur, which eventually lead to destruction of the joint. Some degree of extra-articular involvement is found in most sufferers. These extra-articular manifestations vary widely between subjects but may include systemic symptoms (anorexia, weight loss, myalgia), more localized abnormalities such as rheumatoid nodules, or involvement of the cardiovascular system (vasculitis, pericarditis), respiratory system (pleural effusions, pulmonary fibrosis), or central nervous system (spinal cord compression, peripheral neuropathy).

Onset, most commonly in the third and fourth decades, is insidious in the majority of cases.

Keywords

chronic low back painfibromyalgiamusculo-skeletal disorderosteoarthritispsychiatric disorderrheumatoid arthritis
Type
Chapter
Information
Handbook of Liaison Psychiatry , pp. 527 - 546
Publisher: Cambridge University Press
Print publication year: 2007

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