Single and Multiple Regional Periarticular Pain

This section focuses on a disparate group of conditions which give rise to pain and symptoms in the soft tissues around the musculoskeletal system. They often give rise to non-specific symptoms which can be mistaken for degenerative arthritis if they are not borne in mind as differential diagnosis.

Rotator Cuff Pathology

Disease of rotator cuff affects the young and old in different ways. In the it is usually damaged by an acute traumatic event. This should be recognised and managed expeditiously as a missed injury may be very difficult to surgically treat later down the line. In the elderly the rotator cuff is prone to chronic tears due to tendon degeneration. This group images up the majority of rotator cuff pathology.



Medical and lateral epicondylitis are both common conditions caused by tendon degeneration at the common flexor and extensor origins of the medical and lateral epicondylitis respectively. They are more commonly known as golfers and tennis elbow though these are actually relatively uncommon causes of the conditions.


Trochanteric Bursitis

Trochanteric bursitis is a common condition which affects many people over their lifetime. It can potentially be quite debilitating, causing pain on walking and waking during sleep. It is also a common complication of total hip replacement and may adversely affect patient satisfaction with the procedure.



This is a very common cause of multiple regional MSK pain and disability.  It commonly associates with medically unexplained symptoms in other systems. The crude prevalence in UK and US communities is 2-3%.   Although fibromyalgia can occur at any age, including in teenagers, it shows a progressive increase with age, reaching a maximum prevalence of 7% in women aged over 70.  Female predominance is about 10:1.