Arthritis History

• 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

• 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

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