3. Similar pain or morning stiffness in other areas of the body would increase the suspicion that this represents a more generalized rheumatologic condition (e.g., ankylosing spondylitis, psoriatic arthritis, or endocrine disorder, such as hypothyroidism, hyperthyroidism, or hyperparathyroidism).
4. If fatigue or a sleep disturbance is present, the diagnosis of fibromyalgia should be considered.
B. Pain. The quality of pain, its distribution, and modulating factors are helpful in determining etiology.
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