MSK

Question 1

What questions relate to site of PC?

Answer 1

• what is the pattern of joint involvement?
• which joints are affected?
• small or large joints?
• one or multiple?
• gradual or sudden onset?
• bilateral (If so, symmetrical/asymmetrical)?

Question 2

What should you ask about the onset of the PC?

Answer 2

• when did it start?
• is it episodic: frequency, regularity and duration

Question 3

Which conditions have an acute onset?

Answer 3

• acute: gout
• subacute: septic arthritis, rheumatoid

Question 4

What conditions have chronic onset?

Answer 4

• Osteoarthritis

Question 5

What should you ask about the character of the PC?

Answer 5

• ache, throbbing, sharp?

Question 6

What should you ask about radiation of PC?

Answer 6

• neck > upper limb
• lower back > buttocks/lower limb
• hip > knee

Question 7

What local symptoms are associated with MSK complaints?

Answer 7

• stiffness, swelling, crepitus
• erythema, inc local temp
• nodules
• rash, skin conditions

Question 8

What systemic symptoms are associated with MSK complaints?

Answer 8

• fatigue, malaise, depression
• fever, abdo pain, weight loss
• dry mouth, gritty eyes

Question 9

What are exacerbating factors?

Answer 9

• inflammatory (RA, ankylosing spondylitis): rest
• mechanical (OA): exercise

Question 10

What are alleviating factors?

Answer 10

• NSAIDs
• Exercise/rest

Question 11

What does PRISMS stand for?

Answer 11

• pain
• rashes, skin lesions, nail changes
• Immune
• Stiffness
• Malignancy
• swelling and sweats

Question 12

How do you complete an MSK HPC?

Answer 12

• recent infective episodes (joint sepsis)
• diabetes
• psoriasis, IBD, coeliac
• TB
• AI conditions

Question 13

What are the risk factors for gout?

Answer 13

• alcohol
• renal disease
• low dose aspirin
• diuretics
• metabolic syndrome

Question 14

What family history should you enquire about?

Answer 14

• RA
• OA
• psoriasis
• gout
• UC
• Crohn’s
• connective tissue disease
• autoimmune