Rheumatological History

Question 1

What are the common presenting complaints in MSK patients?

Answer 1

Joint pain/stiffness/swelling

Back pain

Muscular pain/weakness

Shoulder pain

Skin rashes

Question 2

What are the systemic symptoms that must be covered in an MSK history?

Answer 2

1 - Do you have any pain/swelling/stiffness of any joints/muscles?

2 - Do you have any difficulties dressing yourself?

3 - Can you climb stairs without any difficulty?

Question 3

How is OA differentiated from RA?

Answer 3

RA:

• Morning stiffness
• Symmetrical involvement of small joints of hand (DIP joints spared)
• Fatigue

OA:

• Joint pain made worse by activity and worse at end of the day
• Non-symmetrical joint pattern

Question 4

What are the B symptoms that should be asked about in order to rule out malignancy?

Answer 4

Night sweats

Weight loss

Fever

Question 5

What other symptoms/questions might you want to ask an MSK patient?

Answer 5

1 - Any recent infections? (septic arthritis)

2 - Dry eyes? (Sjogrens)

3 - Red/painful eyes (Uveitis/ankylosing spondylitis)