MSK history Flashcards
(26 cards)
Woman 45, acute on chronic joint pain, 70 mins hours stiffness mornings, red eyes
RA [also symmetrical, I think fevers etc.]
Joint pain history
q
Reactive arthritis symptoms; difference from septic and psoriatic?
Reiter’s: can’t see [conjuctivits], can’t pee [urethritis], can’t climb a tree [arthritis], septic more systemic Sx, chlamydia often precipitates, all arthritis [SRP] have skin/nail changes
Joint pain history uncommon questions
associated swelling or stiffness, one/many joints, how long stiffness to wear off, awake night, trauma/injury, bowel/eye/urinary Sx, cough/SOB, SKIN/NAIL changes, PAIN AT NIGHT
Acute inflammation of many joints, associated skin/nail changes
SLE
Asymmetrical arthritis, usually lower limb
IBD [eye pain/blurring, bowel problems, mouth ulcers]
Muscle/joint pain, eye problems, mouth dehydration, rash
Sjogren’s [dryness mouth/eyes/cough/vagina]
Joint pain history
q
Constant back pain, especially at night
Malignancy: carcinoma, myeloma, leukemia
60 y/o, trauma knee, morning stiffness 10 mins
OA
Predispose gout triggers
Alcohol, diuretics, purines [food]
Acute pain joint after 10 hours, something like this has happened before
Gout [also MTP joint, knee, not hand, has happened before, triggers look for]
Steady constant pain at wrists
Pseudogout
Skin and nail changes [plaques scaly]
Psoriatic arthritis [esp. nail changes including pitting, nodules, lots of hand signs though can be elsewhere body, noticable swelling]
Common cause septic arthritis
Gonorrhoea
Joint pain history
q
Back pain history
q
Pain lower back and buttocks, relieved by exercise, eye pain/blurred vision, worse monr.
AS [late teens or 20s]
Back pain questions commonly missed
associated numbness and tingling, awake at night, stop sleep, trouble controlling bladder/bowels, stress currently, pain rest or movement, AWAKE NIGHT, analgesics
Bilateral leg pain, numbness/tingling, relieved by rest/sitting forwards
Spinal/root canal stenosis
Leg pain both legs, numbness, loss of sphincter control
EMERGENCY, spinal cord compression
Sacroilitis, spondylitis, unusal stools
IBD
Pain and inflammation cervical spine
RA
Numbness and parasthesia one leg
prolapsed disc lumbar [often related to injury]
