Joint Pain/swelling/stiffness Hx

Question 1

What is the mnemonic for joint pain ?

Answer 1

O’SOCRATES + 3Ps (including trauma) + SS + IICE

Question 2

For joint pain, What are some possible alleviating factors ? (1)

Answer 2

Improves with movement or exercise (INFLAMMATORY)

Question 3

For joint pain, What are some possible exacerbating factors ? (3)

Answer 3

1. Worse with movement or exercise (DEGENERATIVE)
2. Worse in the morning (INFLAMMATORY)
3. Worse at the end of the day

Question 4

What is the mnemonics and associated symptoms for Joint pain ? (4)

Answer 4

SSRLs
Stiffness: any stiffness ? When and how long ? (>30: INFLAMMATORY; <30: DEGENERATIVE)
Swelling: if so where and when 
Redness/hot
Limited movement/mobility

Question 5

What is the system review made up of ? (3) 😭

Answer 5

Ruling out differentials:

1. General: FAWR
2. SLE: No RMDS
   - Neurological symptoms: headaches, vision problems, sensory loss, weakness
   - Raynaud’s: Painfully cold hands that change colour
   - Mouth ulcers
   - Dryness of eyes and mouth
   - Serositis (SOB and chest pain)
3. Seronegative spondyloropathies (anterior uveitis)

Question 6

What are some other differential for joint pain with regards to acute (3) ?

Answer 6

Acute: SA/GOUT/trauma

Question 7

What are some of the chronic DDx ? (3)

Answer 7

Chronic:

• inflammatory: RA and seronegative spondylopathies
• non inflammatory: OA