ABSTRACT
Chronic joint pain is one of the leading causes of suffering and disability worldwide. Joint pain is usually more prominent and more persistent than in osteoarthritis, occurring at rest, at night, and on activity. The most common causes of polyarticular pain include viral arthritis, osteoarthritis, inflammatory polyarthritis, fibromyalgia, and soft tissue problems whereas the differential diagnosis of pain in or around a single joint includes trauma, infection, and crystal disease. Important presenting symptoms in joint disease are pain, stiffness or locking, swelling, weakness or difficulty moving, fatigue, and emotional lability such as anxiety or depression. In addition to the symmetrical peripheral joint involvement, the cervical spine may also be involved. The synovium-lined atlantoaxial joint and/or the posterior apophyseal joints may become inflamed, causing pain in the neck and occipital headache. Uncontrolled disease eventually results in inflammation spreading beyond the synovium of the joint to other nearby structures, including the tenosynovium of tendons, ligaments, other soft-tissue structures, and bone.
