History

• Approaching a patient with 'arthritis'

  • Number of joints (if one, think septic arthritis)
  • Distribution - migratory (moving joints) vs additive (starting in one joint and then progressing to others)
  • Onset - acute or chronic
  • Effect on physical activity e.g. early morning persisting stiffness suggests inflammatory condition
  • Systemic or extra-articular manifestations
• Rheumatoid arthritis is typically a polyarthritis (>5 joints) and is symmetrical
• Oligoarthritis involves 2-5 joints

  • Crystal arthritis
  • Psoriatic arthritis
  • Reactive arthritis
  • Ankylosing spondylitis
  • Osteoarthritis (can be polyarthritis, symmetrical)