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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