Musculoskeletal History

 3 screening questions:

• Any pain, swelling, or stiffness in joints/muscles?
• Any difficulty getting dressed?
• Any difficulty getting up stairs?
• If they answer yes to any one, proceed to establish if it is inflammatory, the joint pattern, the time course, and associated symptoms.

Inflammatory joint disease features:

• Joints: swelling, redness, warmth.
• Morning stiffness longer than 30 minutes.
• Improved by movement.
• Systemic symptoms: fever, night sweats, rash, weight loss.

Non-inflammatory joint disease features:

• Joint: instability, locking.
• May or may not have swelling or stiffness.
• Worsened by movement.

Time course:

• Acute vs. chronic.
• Episodic e.g. RA, gout.
• Progressive: cancer.

Further questions:

• Precipitant: trauma, infection.
• Nocturnal symptoms: may suggest malignancy.