Musculoskeletal

Radiographic axial spondyloarthritis causing inflammatory back pain, sacroiliitis and progressive structural new bone formation in susceptible people.

Bone tumours include benign lesions, rare primary bone sarcomas, myeloma and secondary deposits; the high-yield task is to recognise persistent or unexplained bone pain, swelling, a pathological fracture or an aggressive radiograph, investigate promptly and ensure that suspected primary bone tumour is referred before biopsy to an expert sarcoma centre.

Bursitis is inflammation or infection of a fluid-filled bursa, usually causing a localised swelling over a pressure point; the safety-critical task is to distinguish non-septic bursitis from septic bursitis, septic arthritis, crystal disease and a mass.

Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) is a disabling long-term illness diagnosed from a characteristic symptom pattern, especially post-exertional malaise, after assessment for alternative and coexisting conditions; management is person-led energy management and symptom support, not fixed graded exercise.

Axial or peripheral spondyloarthritis associated with Crohn’s disease or ulcerative colitis, requiring coordinated gastroenterology and rheumatology care.

Fibromyalgia is a chronic primary pain condition characterised by widespread pain with fatigue, unrefreshing sleep and cognitive difficulty; it is diagnosed clinically while assessing mimics and coexisting disease, and managed with person-centred exercise, psychological approaches, symptom care and selective medicine review rather than routine analgesics.

A large- and medium-vessel vasculitis in people over 50 that can cause irreversible visual loss, requiring immediate glucocorticoid treatment when strongly suspected and urgent specialist confirmation.

Juvenile idiopathic arthritis (JIA) is persistent inflammatory arthritis beginning before the 16th birthday and lasting at least 6 weeks after other causes have been considered. It is a group of diseases in which silent anterior uveitis, joint damage, growth disturbance and systemic inflammation make early specialist assessment essential.

Most low back pain is non-specific and improves with activity and self-management, but every assessment must identify cauda equina syndrome, fracture, infection, malignancy and inflammatory disease that require a different pathway.

A clinical syndrome of joint pain, stiffness and functional limitation in which tissue remodelling, load, prior injury and low-grade inflammation interact; treatment is guided by symptoms and function, with exercise and weight management as the core interventions.

Osteomalacia is defective mineralisation of newly formed adult bone, most often from vitamin D deficiency or phosphate depletion. It causes diffuse bone pain, proximal weakness and fragility or pseudofractures, with a pattern of abnormal mineral metabolism rather than the normal biochemistry of osteoporosis.

Osteomyelitis is infection of bone acquired through the bloodstream, from adjacent tissue or by direct inoculation. It can progress to abscess, dead bone, sinus formation, vertebral neurological compromise or limb-threatening diabetic foot disease, so early cultures, imaging, specialist antibiotics and source control are central.

A systemic loss of bone strength that is usually silent until a fragility fracture, assessed with clinical fracture risk and bone density and managed with falls prevention, risk-appropriate bone protection and planned treatment follow-up.

An inflammatory syndrome in adults over 50 causing new bilateral shoulder or pelvic-girdle pain and prolonged stiffness, diagnosed by clinical pattern and exclusion of mimics, with urgent screening for associated giant cell arteritis.

Polymyositis and dermatomyositis sit within the idiopathic inflammatory myopathies, a group of multisystem autoimmune diseases causing objective muscle weakness and sometimes characteristic skin, lung, swallowing and cardiac disease. In adults, dermatomyositis and selected antibody phenotypes also signal increased malignancy risk.

A heterogeneous inflammatory arthritis associated with psoriasis, characterised by combinations of peripheral arthritis, axial disease, enthesitis, dactylitis and nail involvement.

Raynaud's phenomenon is episodic digital vasospasm triggered by cold or stress, causing sharply demarcated colour change, numbness and pain. Primary disease is usually benign, but later-onset, asymmetric or tissue-damaging disease may be secondary to systemic sclerosis, another connective-tissue disorder, large-vessel disease, vibration or medicines.

A sterile inflammatory arthritis that develops after a gastrointestinal or genitourinary infection and commonly follows an asymmetric spondyloarthritis pattern.

A systemic inflammatory synovitis that can irreversibly damage joints and organs; refer persistent synovitis urgently and start specialist-led treat-to-target DMARD therapy early.

Sarcopenia is muscle failure characterised by low strength, while frailty is reduced reserve across several systems that makes a person vulnerable to disproportionate decline after a minor stressor; they commonly coexist but require different assessments.

Bacteria in the joint space trigger a neutrophil response whose enzymes digest articular cartilage within days, so the inflammation destroys the joint faster than the organism does.

Sjogren disease is a chronic autoimmune condition causing ocular, oral and other mucosal dryness, with possible joint, skin, lung, renal, neurological and haematological involvement; persistent gland swelling or systemic features need specialist assessment because lymphoma risk is increased.

A family of inflammatory arthritides with axial or peripheral patterns, enthesitis, dactylitis and characteristic extra-articular disease involving the eye, skin and gut.

A lifelong multisystem autoimmune disease in which loss of tolerance produces autoantibodies and inflammation across skin, joints, kidneys, blood, serosa and the nervous system.

Systemic sclerosis is a multisystem autoimmune disease combining small-vessel vasculopathy, immune activation and fibrosis; it can threaten the digits, lungs, pulmonary circulation, heart, kidneys and gut, so early specialist risk stratification and structured surveillance are essential.

Vasculitis is a group of disorders in which vessel-wall inflammation causes ischaemia, aneurysm or haemorrhage; vessel size and the organ pattern guide diagnosis, urgency and treatment.