Abstract
Familial Mediterranean fever (FMF) is a genetic disease characterized by painful febrile attacks of serositis. One of the most important serosal attacks is monoarthiritis. Besides arthiritis, many other musculoskeletal manifestations (MSM) have been reported. MSM of FMF could be classified as acute and chronic or protracted. Acute MSM includes joint attacks, muscle attacks and skin attacks. Chronic or prolonged MSM includes protracted arthritis and protracted febrile myalgia (PFM). Recurrent acute monoarthiritis is one of the diagnostic criteria included both in Tel Hashomer and Yalcinkaya criteria. Misdiagnosis of this presentation as acute romatic fever is possible. Muscle attacks present in different forms; one of them is exertional leg pain and the other is recurrent febrile muscle attacks. Chronic MSM of FMF is rare, but important for differential diagnosis. PFM is an attack lasting 6-8 weeks with debilitating myalgia. Differential diagnosis with polyartheritis nodosa is required. Protracted arthritis affects the hips or the knees and requires corticosteroids or sometimes surgery. Sacroiliitis in FMF patients should be evaluated in this group. These MSM presentations of FMF are important in patients who are not yet diagnosed as FMF. Unawareness of these manifestations could cause misdiagnosis and delay.
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