History Taking

Question 1

What questions do you want to ask in a rheumatology history?

Answer 1

1. Are the symptoms from the joints or the soft tissues?
2. Is the condition chronic or acute?
3. Is the condition inflammatory or no-inflammatory? - pain, stiffness, joint swelling
4. What is the pattern of the affected areas/joints?
5. What is the impact on the patient’s life?
6. Are other systems involved?

Question 2

What do you ask in a history presenting with pain and swelling in both hands?

Answer 2

1. When did symptoms start - sudden or gradual?
2. Do symptoms typically vary throughout the day? - morning stiffness, exercise, when at worst
3. Have you noticed any other symptoms? - fever, rashes, dry eyes
4. Do any joint problems run in the family? e.g. skin psoriasis

Question 3

What conditions show monoarthritis?

Answer 3

• Septic arthritis
• Crystal arthritis (gout, CPPD)
• Osteoarthritis
• Trauma (haemarthrosis)

Question 4

What conditions have oligoarthritis?

Answer 4

= 5 joints

• Crystal arthritis
• Psoriatic arthritis
• Reactive arthritis
• Ankylosing spondylitis
• Osteoarthritis

Question 5

What conditions show symmetrical polyarthritis?

Answer 5

• Rheumatoid arthritis
• Osteoarthritis
• Viruses e.g. hepA, mumps
• Systemic conditions

Question 6

What conditions show asymmetrical polyarthritis?

Answer 6

• Reactive arthritis
• Psoriatic arthritis
• Systemic conditions