Table 9.

All-grade adverse events of musculoskeletal and rheumatological origin in cancer patients treated with ICI [71, 74, 77–81]

System	Organ	Symptoms	Abnormalities in diagnostic test results	Suspected pathology
Musculoskeletal system	Joints	Inflammatory signs (mild)	Abnormalities in physical examination	Arthralgia/myalgia
		Swelling Pain Warmth Redness Arthralgia Stiffness after inactivity/in the morning Joint tenderness Range of motion	Physical examination (signs of inflammation) Laboratory testing (ANA, RF, anti-CCP, ESR, CRP) X-ray/USG/MRI (signs of inflammation, joint damage-erosions)	Inflammatory oligo-/polyarthritis
	Muscles	Muscle weakness Motor delay Respiratory impairment Bulbar muscle dysfunction	Normal/ elevated CK Nerve conduction study (low amplitude compound muscle action potentials/normal) EMG (irritable myopathy/normal) MRI of affected muscles Muscle biopsy	Myopathy
		Muscle inflammation Muscle weakness Muscle pain Mild myalgia Rhabdomyolysis Life treating if respiratory muscles/myocardium involved	Elevated muscles enzymes (CK) Blood testing (transaminases-AST, ALT; LDH; aldolase elevated) Inflammatory test: CRP Myositis antibody panel EMG (findings of myositis) MRI (of appropriate muscle section for biopsy) Muscle biopsy	Myositis
		Marked pain Stiffness in proximal upper and/or lower extremities No true muscle weakness Difficulty in active motion related to pain No signs of true muscle inflammation	Laboratory test (high CRP, elevated OB, anemia, thrombocytopenia, elevated liver enzymes, no CK elevation) USG/MRI (synovitis of joints and tendon sheaths)	Polymyalgia-like syndrome
		Dry eye Mouth dryness (suddenly developing, exacerbated at night) Parotitis Inflammatory myositis Inflammation of the salivary glands Thick, sticky saliva Dry throat, hoarseness Changed taste, sensitivity to spicy and sour foods	Oral mucosa changes indicating insufficient salivary gland function USG (mild changes in the major glands, including parenchymal heterogeneity with hyperechogenic bands and scattered ovoid hypoechoic lesions) Salivary gland biopsy (mild nonspecific chronic sialadenitis with acinar atrophy and fibrosis)	Sicca syndrome