Overview of the diagnosis of inflammatory rheumatological diseases in adults

For advice on the diagnosis of musculoskeletal conditions in children and adolescents, see Diagnosis of musculoskeletal conditions in children and adolescents.

Sometimes, differentiating common benign musculoskeletal conditions from more serious inflammatory rheumatological diseases can be challenging. This section provides guidance about which features are more typical of inflammatory rheumatological diseases.

Note: Adults with new onset of unprovoked musculoskeletal symptoms may have an inflammatory rheumatological disease in its early stage.

Adults with new onset of unprovoked musculoskeletal symptoms may have an inflammatory rheumatological disease in its early stage. Both modifiable and intrinsic factors influence their predisposition to develop a specific inflammatory rheumatological disease. Most inflammatory rheumatological diseases are diagnosed clinically based on:

history (eg characteristic symptoms of specific conditions, predisposition to specific conditions)
examination (eg patterns of musculoskeletal symptoms, presence or absence of extra-articular features)
investigations—not necessarily required, but may confirm a specific diagnosis or answer a specific question.

The diagnosis of inflammatory rheumatological conditions can be complex and lengthy. Arthritis is a common symptom of many inflammatory rheumatological conditions and until the diagnosis is confirmed, specialists often refer to early presentations as ‘suspected inflammatory arthritis’.

If the history is suggestive of inflammatory arthritis (with or without physical signs), the condition may be termed a ‘suspected inflammatory arthritis’ until a definitive diagnosis is found or the symptoms resolve. See Approach to suspected inflammatory arthritis for more details.