Weight loss chronic cough change in bowel habits night pain or other constitutional symptoms may suggest an underlying malignancy

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.

5. Morning stiffness or back pain that improves with exercise should prompt consideration of a seronegative spondyloarthropathy.

B. Pain. The quality of pain, its distribution, and modulating factors are helpful in determining etiology.

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