A 33-year-old female reports general malaise,fatigue,stiffness,and pain in multiple joints of the body.There is no history of systemic disease and no history of trauma.On physical examination,the patient has no swelling or decreased range of motion in any of the joints.She indicates specific points on the neck and shoulders that are particularly affected.She complains of tenderness upon palpation of the neck,both shoulders,hips,and medial regions of the knees.The clinician should include the following disorder in the list of potential diagnoses:

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The symptoms and physical examination findings suggest fibromyalgia, which is characterized by widespread pain, tender points, and fatigue. Osteoarthritis typically presents with joint pain and stiffness, but not widespread tenderness. Rheumatoid arthritis can present with joint swelling and a more symmetric pattern of involvement, whereas this patient's symptoms are more diffuse. Polymyalgia rheumatica can cause stiffness and pain in the neck and shoulder girdle, but it typically occurs in patients over the age of 50 and is less commonly associated with tenderness in other areas, such as the hips and knees.

A 33-Year-Old Female Reports General Malaise,fatigue,stiffness,and Pain in Multiple Joints