MSK Focused Hx

MSK Focused Hx

1. Joint Pain

2. Joint Stiffness

   • HPI
     • SOCRATES
     • - N. of joints involved - Symmetry - Size of joints - Sequence of involvement - Progression - Chronicity - Range of motion
       • other Histories
         • PMH
           • - Similar previous episodes -H/O trauma/sprain - H/O thyroid/inflammatory bowel disease
         • FMH
           • Autoimmune conditions ( RA/OA/IBD/AS/Reiters/ similar symptoms experienced by family memebers
         • SUH
           • joint/back surgery/replacement
         • SOH
           • nature of occupation (active/sedentary)/ consumption of purine rich food/IV drug abuse
         • medication
           • analgesia (type & frequency)/ diuretics, Ca supplements, antidepressants, immunosuppressants
     • Ddx- specific HPI:
       • Rheumatoid--> worse in the morning
       • Septic --> Fever/acute onset/ trauma
       • Gout: excruciating pain
     • Ddx specific HPI
       • Ankylosing spondylitis: low bk pain, improvement with exercise
       • Polymyalgia Rheumatica: confined to neck/shoulder/pelvic girdle
     • Ddx specific HPI:
       • Osteoarthritis: asymmetry
       • SLE: Fever/fatigue/photosensitivity
       • Sjogrens: dry eyes/mouth

3. Joint Swelling