History Taking

Question 1

Important things to cover in history taking

Answer 1

• Understand the severity of the person’s symptoms and the impact on day to day activities: their mobility, ability to perform ADLs, work and social roles etc.
• Distinguish inflammatory vs non-inflammatory causes of joint pain
• What is the pattern of affected joints?
• Identify mechanical symptoms? (e.g. locking of the joint or giving way).
• Identify potentially significant previous problems (e.g. cancer, psoriasis; recurring conditions (e.g. gout)
• Identify family history of musculoskeletal conditions that may be inherited
• Identify occupational triggers, e.g. repetitive movements, lifting, posture

Question 2

GALS screening

Answer 2

Initially:

1. Do you have any pain or stiffness in your muscles, joints or back?
2. Can you dress yourself completely without any difficulty?
3. Can you walk up and down the stairs without any difficulty?

Gait - Smoothness, symmetry and the ability to turn quickly
Assess for shoulder muscle bulk, symmetry and spinal alignment, gluteal muscle bulk, iliac crest alignment, popliteal swelling/abnormalities, hindfoot abnormalities
Spine - curvatures, assess for lumbar movement by asking pt to touch their toes, neck side to side
Arms- in anatomical position. Hands behind their heads, hands prone with elbow flexion, supinate, make a fist, precision pinch, grip strength test
TMJ pain may be associated with inflammatory arthritis so open mouth and move jaw side to side
Legs- knee flexion, hip flexion, internal rotation of hip, patella tap
Inspect feets, MCPJ joint squeeze

GALS NAD recorded if no obvious issues.