- CC: most likely will present as joint pain;
- Site: where? Other joints? Does it radiate anywhere else?
- Onset: first time? when? Sudden\gradual? Continuous\intermittent? Getting better\worse? Provoked by GI\URT infection or trauma?
- Duration: how long does it last?
- Timing: specific time of day\night? How frequent?
- Characteristic: dull?
- Relieving\aggravating factors: movement? Rest? Medications?
- Severity: 1-10 scale? Wakes you up from sleep? Interfering w\ ADL?
- Associated sx:
- Constitutional: fever, wt loss, loss of appetite, night sweats, chills?
- Joint sx: swelling, redness, limited\pain with movement?
- RA: morning stiffness?
- OA: crepitations?
- SLE: rash, hematuria, alopecia?
- Scleroderma: Raynaud’s?
- Psoriasis: nail changes, swelling of fingers?
- Ankylosing spondylitis: blurred vision, back pain?
- Myositis: muscle pain?
- PMHx:
- Diseases:
- Chronic ds (HTN, DM, DLP)
- Autoimmune, infections
- Medications: NSAIDs, abx
- Surgery, hospitalization, trauma
- Blood transfusions, IV drug use, tattoos
- Allergies
- Diseases:
- FMHx:
- Similar complaint?
- Same diseases as in PMHx?
- Social Hx:
- Occupation, marital status, children?
- Smoking, alcohol, recreational drugs?
- Travel Hx, contact with sick pts?
- Diet (high protein), exercise
DDx mono and poly arthritis?
- Mono: OA, lyme’s, septic, trauma, hemarthrosis, gout, pseudo gout, avascular necrosis
- Poly: RA, SLE, spondylarthrosis, poly\dermato-myositis