Musculoskeletal pains are sometimes misdiagnosed in some diseases, like rheumatoid and psoriatic arthritis, erosive osteoarthritis (OA), etc.
Secondary hyperparathyroidism was not considered a differential diagnosis for rheumatoid arthritis (RA), despite the fact that it can cause arthralgia or arthritis.
Also, fibromyalgia is a psychosomatic condition marked by widespread pain and tenderness.
The present study included 400 patients who attended certain outpatient clinics of Rheumatology in Egypt and Saudi Arabia, who were not fulfilling criteria for RA diagnosis.
Criteria for the classification of fibromyalgia syndrome were applied to all patients. Researchers did lab tests and radiological imaging modalities for diagnosis or exclusion of suspected diseases were applied.
All patients were fulfilling both old and new criteria of fibromyalgia syndrome, and not fulfilling any RA criteria, and had vitamin D3 deficiency or insufficiency.
75% of patients had abnormally high levels of PTH, without parathyroid gland pathology.
Radiology showed subperiosteal and subchondral resorption of thumbs mainly, subchondral osteopenia of proximal and middle phalanges, mild subperiosteal resorption along the radial aspect of the middle phalanx and mild tuft erosions, besides changes in the carpus closely resembling those of rheumatoid arthritis, of ulnar styloid resorption, radiocarpal and scaphoid-trapezoid joint arthritis. Of special interest, the presence of tuft spur-like excrescences.
Published: 15 November 2021
source:
https://www.nature.com/articles/s41598-021-01698-1
https://doi.org/10.1038/s41598-021-01698-1
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