Ortho and rheum exploring symptoms

Question 1

Back Pain

Red Flags for back pain:

Cauda equina

Infection/Cancer

Answer 1

SOCRATES

Sciatica sx
Early morning stiffness
Urinary incontinence, faecal incontinence/constipation
Temperature - infection sx.

Cauda Equina - Urinary incontinence/retention
Faecal incontinence/constipation, Bilateral leg pain, severe progressive neuro deficit.

Infection/Cancer: <20 or >55 
weight loss 
fever 
night sweats
cancer history 

Infection - recent infection, iv drug user, fever night sweats.

Trauma -
severe central spinal pain
structural spine deformity
spinal tenderness.

Spondyloarthropathy -
Early morning stiffness, night pain and worse with rest.

Question 2

Joints/Stiffness/Swelling

Answer 2

Is it worse in the morning
longer than 30 minutes? - inflammatory cause

Better with exercise (Inflammatory) or worse (Osteoarthritis)

sleep disturbance
loss of function
associated rheumatological symptoms

Question 3

Bone/Tissue/Joint injury

Answer 3

stiffness/swelling
movement restrictions
ability to weight bear
mechanical symptoms - locking, giving way
neurological symptoms - weakness, numbness, paraesthesia