What causes nonarticular rheumatism/regional pain syndromes?

Updated: Apr 04, 2018
  • Author: T P Sudha Rao, MD; Chief Editor: Herbert S Diamond, MD  more...
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The cause of fibromyalgia has not been elucidated. A possible link between chronic fatigue syndrome and a little-known infectious retrovirus, xenotropic murine leukemia virus–related virus (XMRV) [18]  proved unreliable. [19]

Associated conditions, but not necessarily etiologic factors for fibromyalgia, may include the following:

  • Severe flulike syndrome
  • Autoimmune diseases (eg, rheumatoid arthritis [RA], systemic lupus erythematosus [SLE])
  • A defined infection (eg, Lyme disease, hepatitis C, HIV)
  • Trauma (eg, a motor vehicle accident)
  • Chronic disturbed sleep
  • Family history of fibromyalgia
  • Female sex
  • Psychological stress and depression
  • Emotional trauma

Many of the above associated factors may contribute to multiple bursitis-tendonitis syndrome, which may be a subset of fibromyalgia.

Possible etiologic factors for other conditions include the following:

  • Regional and local bursitis and tendonitis are often associated with repetitive motion and localized trauma
  • Fluoroquinolones have been linked to tendonitis, as have systemic disorders such as rheumatoid arthritis and spondyloarthropathies
  • Carpal tunnel syndrome may be idiopathic or may be associated with pregnancy, endocrine disorders (eg, hypothyroidism, acromegaly), wrist synovitis (eg, rheumatoid arthritis, gout, pseudogout), and systemic illnesses such as amyloidosis (eg, primary, secondary to hemodialysis)
  • Hypermobility syndrome appears in familial clusters, indicating a genetic predisposition. Defined genetic disorders characterized by joint laxity include Ehlers-Danlos syndrome, Marfan syndrome, and pseudoxanthoma elasticum.

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