Spectrum of rheumatologic disorders among patients attending with musculoskeletal symptoms: experience from medicine outpatient department of a tertiary care hospital of Bangladesh

Abstract

Background: Musculoskeletal conditions are prevalent and their impact is pervasive. They are one of the most common causes of long-term pain; affect hundreds of millions of people around the world; they significantly affect the psychosocial status of the affected people as well as their families and carers. This study was done to evaluate the spectrum of rheumatologic disorders among patients attending at medicine outpatient department (OPD) with musculoskeletal symptoms.

Methods: This cross-sectional study was done at OPD of Medicine, BIRDEM General Hospital from January 2014 to June 2017. All patients attending at OPD having musculoskeletal symptoms, who fulfilled criteria of definite rheumatologic disease and known rheumatologic disorders were consecutively and purposively included in this study.

Results: Total patients were 495 with female predominance (71.31%). Mean age was 48.6 years (range 18-76 years). Among the study population majority had inflammatory joint and spine diseases (69.69%);then degenerative joint and spine diseases (22.02%), connective tissue diseases (2.22).Two-thirds of the patients had rheumatoid arthritis (RA) (76.23%) among inflammatory joint and spine diseases, then ankylosing spondylitis (AS) (13.33%).Regarding connective tissue disease, systemic lupus erythematosus (SLE) was more frequent (45.5%). Among soft tissue rheumatism and metabolic bone disease, all study subjects had fibromyalgia (FM) and osteoporosis respectively. Rheumatoid factor was positive among two-thirds and anti-CCP antibody in twofifths of RA cases, HLA-B27 was positive in 4.3% of AS, antineuclear antibody (ANA) and anti-ds DNA were positive in all SLE patients. Common co-morbidities were diebetes (41.4%), ischaemic heart disease (20.6%) and hypertension (19.1%).

Conclusion: RA was the most common inflammatory joint disease. Degenerative diseases were the second most common condition. Common connective tissue disease was SLE.

Birdem Med J 2021; 11(2): 116-120