history

Last reviewed 01/2018

• background information: age, sex, race, occupation

These are important essential elements to the history as many rheumatological conditions are restricted to certain elements of the population. For example, osteoarthritis occurs more commonly with increasing age, and certain conditions are more common in women ie SLE, or men ie Reiter's.

• features of joint pain: duration, onset, distribution, severity, periodicity

The chronicity of symptoms may favour the diagnosis of rheumatoid arthritis versus other more acute conditions, similarly a characteristic onset, distribution and severity may favour the diagnosis of gout. Increased symptoms in the morning ie stiffness versus the evening is characteristic of ankylosing spondylitis.

• associated features: skin conditions, family history, previous medical history, other non-articular symptoms

A personal or family history of psoriasis may be significant, as may previous symptoms that might suggest the presence of a systemic disease. For instance a dry mouth might be suggestive of Sjogren's syndrome.

• disability and previous treatment

It is important when gauging the severity of a condition and when considering management that the effect on the patient's life is assessed.