Acute joint swelling in adults : Initial assessment

When assessing adults presenting with joint pain in primary care, healthcare providers should adopt a comprehensive approach that includes a detailed history, physical examination, and consideration of potential underlying causes.

History Taking

1. Pain Characteristics:
   • Determine the onset, duration, and pattern of the pain. Is it acute or chronic?
   • Assess the location and whether it affects one or multiple joints.
   • Identify factors that aggravate or relieve the pain, such as movement or rest.
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2. Associated Symptoms:
   • Look for systemic symptoms like fever, weight loss, or fatigue that may indicate a systemic condition.
   • Inquire about morning stiffness, which can suggest inflammatory arthritis if it lasts more than an hour.
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3. Functional Impact:
   • Evaluate how the pain affects daily activities and quality of life.
   • Ask about any limitations in movement or activities due to pain.
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4. Medical and Family History:
   • Review past medical history for conditions like arthritis or gout.
   • Consider family history of joint diseases, which may suggest a genetic predisposition.
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5. Lifestyle Factors:
   • Discuss lifestyle factors such as exercise, occupation, and any recent injuries.
   • Consider the impact of weight and diet on joint health.