AB1204 MUSCULOSKELETAL MANIFESTATIONS IN PATIENTS WITH ENDOCRINE DISORDERS IN AN AMAZON OUTPATIENT CLINIC

Abstract

BackgroundChronic pain is frequently associated with these conditions and is an important cause of care in the health service. This pain is among the main manifestations of the musculoskeletal system, and 40% of individuals can manifest this type of pain at some point in their lives. That is why it is important to have doctors prepared to make an adequate approach to the symptomatology and especially to the underlying diseases. Rheumatic manifestations are part of the manifestation of systemic diseases, in which include diseases of the endocrine system, which can mimic rheumatic conditions. Despite the ignorance of some, endocrine diseases are underlying diseases linked to musculoskeletal manifestations. Thus, secondary arthropathies of non-rheumatologic origin or osteoarticular complaints that simulate or show rheumatic diseases can be found in patients with endocrine diseases during their evolution or in the initial phase along with other systemic symptoms. Based on this concept, we carried out the follow-up and evaluation of musculoskeletal manifestations presented by patients with endocrine disorders in a tertiary health service.ObjectivesThe aim of this study is to characterize the musculoskeletal manifestations in patients with endocrine diseases: type 1 and type 2 Diabetes Mellitus; hypothyroidism; hyperthyroidism and pituitary diseases and to clinically classify the patients based on physical examination and imaging findings.MethodsA cross-sectional and descriptive study, where clinical screening was performed at the endocrinology outpatient clinic, in which patients with musculoskeletal complaints were identified. These patients were referred for evaluation with a rheumatologist with clinical, laboratory and imaging investigation for the diagnosis of rheumatic disease. A questionnaire with epidemiological and clinical data was applied.ResultsTo date, 466 patients diagnosed with endocrine diseases have been interviewed, 53.4 ± 14.7 years old, 371 (79.6%) were female and 95 (20.4%) were male. Of the patients interviewed, 326 (70.1%) reported musculoskeletal pain. In relation to endocrine diseases, the most frequent one was type 2 DM with 212 patients (45.5%), and 77.25% of these people have chronic musculoskeletal pain, most of them 5 to 7 times a week, showing an intrinsic character of this disease with pain complaints from a great part of this population. The prevalence of 27.3% of hypothyroidism, 10.7% of DM type 1, 7.1% of hyperthyroidism, and less expressive amounts of other endocrine diseases such as acromegaly (1.7%), giantism (0.4%), and the like were also identified. About 59.6% of those who have pains are not followed up in the rheumatology service, 41.3% of these have already indicated these pains to their endocrinologist, however they did not have their complaint properly signaled. Of those interviewed, 94 (37.5%) take antihypertensives and 32.7% oral anti-diabetics. The most commonly found diagnoses in rheumatic diseases: Rheumatoid Arthritis (39%); Osteoarthritis 22.9% and Fibromyalgia 20%; Osteoporosis 19%, Tendinitis calcaria, Psoriatic Arthritis and GOTA with 5.7%. The main joints affected were: Hands (54.4%); Knees (45.3%) and feet (41.8%).ConclusionOur research with pre liminal results has demonstrated the mutuality between endocrine diseases and musculoskeletal manifestations and, therefore, that rheumatologic diagnoses are increasingly frequent in this population. The high prevalence of these symptoms secondary to endocrine diseases raises serious questions to improve the quality of life of these patients, and also to increase the number of investigations in this field, because the pathophysiological mechanisms of this association are not well elucidated and, from there, to expand this information to professionals who may not be aware of this relationship.