Rheumatological History Flashcards
What 3 screening questions are asked?
Do you have pain, swelling or stiffness in joints/muscles?
Do you have difficulty getting dressed?
Do you difficulty getting upstairs?
Inflammatory joint disease:
What 4 things do you ask about?
You need to ask about morning stiffness. Over how many minutes would you think something is going on?
Stiffness usually improves with movement!
What systemic symptoms may they have?
Pain
Swelling
Redness
Warmth
MS>30 minutes - e.g. RA
Fever
Night sweats
Rash
Weight loss
Non-inflammatory joint features:
Locking is important to ask about. What disease can cause locking of joints?
Does non-inflammatory joint disease get better or worse with movement?
Locked or catching joints (aka trigger finger) Deformities or rheumatoid nodules due to the thickening of the synovial lining can cause the fingers to lock in unusual positions as the person tries to bend them; this can sometimes occur in early-stage RA as well as in late-stage.
It usually gets WORSE!!!
Time course:
Obviously acute vs chronic!
What would episodic disease suggest?
What would progressive disease suggest?
RA, Gout
Cancer
What precipitants should you ask about?
Trauma
Infection
Extra-articular features:
What disease are you trying to tease out by asking the following:
- Do you have any rashes or photosensitivity?
- Do you have Raynaud’s/get lose of blood flow to your fingers? - 2
- Do you get dry eyes or mouth?
- Do you get red eyes or iritis?
- Do you have diarrhoea or urethritis?
- Do you have nodules or nodes anywhere? - 2
- Do you have weight loss?
SLE
SLE
Systemic sclerosis
Sjögren’s
AS
Reactive arthritis
RA
Gout
Malignancy
Related diseases:
What joint disease is related to IBD?
AS
What current and past drugs should you ask about which are used in rheumatology?
NSAIDs
DMARDs
Biological agents
Social history:
What disease is common in afro-carribean and asian?
How do you ask about their ability to function?
SLE
Dressing
Grooming
Writing
Walking
What causes monoarthritis? - 3
READ PAGE 539 FOR ARTHRITIDES!
Septic arthritis
Crystal arthritis (gout/CPPD)
Osteoarthritis
READ PAGE 539 FOR ARTHRITIDES!
