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Samantha Cooray, Alexander Deng, Tim Dong

There is much excitement about the deployment of artificial intelligence (AI) in healthcare, and the musculoskeletal field is no exception. In this article, we introduce some of the latest developments relating to osteoarthritis (OA), osteoporosis, rheumatoid arthritis (RA) (as an example of inflammatory arthritis), connective tissue disease (CTD), Ehlers–Danlos syndrome (EDS) and musculoskeletal surgical interventions. […]

Nina Muirhead: Updated NICE ME/CFS Guidance

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Published Online: Oct 29th 2021

It was a pleasure to speak with Dr Nina Muirhead (Buckinghamshire Healthcare NHS trust, Amersham, UK) about the updated guidelines on the diagnosis and management of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The guidance has been designed to improve awareness and understanding to aid early diagnosis.

A list of the symptoms for suspecting ME/CFS is included below and the updated NICE guidance can be found here: NICE ME/CFS guideline outlines steps for better diagnosis and management

  • Symptoms for suspecting ME/CFS
  • Debilitating fatigue
  • Post-exertional malaise or symptom exacerbation, sometimes for hours days or weeks
  • Unrefreshing or disturbed sleep
  • Cognitive impairment
  • Orthostatic intolerance and autonomic dysfunction
  • Dizziness
  • Palpitations
  • Fainting
  • Nausea
  • Worsening symptoms on standing or sitting upright from a reclining position
  • Temperature hypersensitivity
  • Profuse sweating
  • Chills
  • Hot flushes
  • Feeling very cold
  • Neuromuscular symptoms, including twitching and myoclonic jerks
  • Flu-like symptoms
  • Sore throats
  • Muscle aches
  • Intolerance to alcohol, or to certain foods, and chemicals
  • Heightened sensory sensitivities, including to light, noise, touch and smell
  • Pain, including pain on touch, myalgia
  • Headaches, eye pain
  • Abdominal pain
  • Joint pain without acute redness, swelling or effusion

Questions:

  1. Could you tell us a little about myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS) and the reasons behind the recent update of the NICE guidance? (0:26)
  2. What have been the failings of previous approaches to the diagnosis and management of people with ME/CFS? (0:51)
  3. What are the key take-home messages of the new guidance? (1:22)
  4. How will these recommendations impact clinical practice? (2:03)

Support: Interview and filming supported by Touch Medical Media. Interview conducted by Gina Furnival

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