Hip Pain History Questions SOCRATES questions Context and aggravating questions: Ask generally Cold weather Context at onset Lifestyle changes morning ot nighttime stiffness Movement Associated features Rash Back pain Knee pain Deformities Nail changes Joint locking Joint stiffness Sausage fingers Morning stiffness Swelling Erythema Motion limitations Medications Prescriptions Non-prescriptions Past medical history Malignancy Past medical history MSK history GIT disease history Family history Social history Diet Exercise Smoking history Alcohol Differentials RA: Morning stiffness Rash Back pain Knee pain Polyarthritis -> symmetrical pain and swelling of affect joints. Joint involvement -> MCP, PIP, wrist, knees, MTPs. Joint dermatitis -> swan neck, ulnar deviation PA: Back pain Knee pain Joint stiffness Oligoarthritic -> less than 4 joints Polyarthritis -> appearance similar to RA Arthritis mutilans -> destruction of DIP and PIP )interphalangeal joints) Axial involvement -> spine and sacroiliac joints. Sausage fingers Nail involvement -> pitting, onycholysis Uveitis Tenosynovitis Family history OA: Back pain Knee pain Pain during or after movement Relieved with red Crepitus on joint movement Morning stiffness of less than 30 minutes Usually asymmetrical Heberden nodules -> DIP Bouchard nodules -> PIP Joint locking Joint stiffness Family history Gout Back pain Knee pain Pain with overlying erythema Decreased range of motion Swelling Warmth More likely to occur at night and wake the patient at night Bone tophi formation Soft tissue tophi Podagra Family history Injury Osteomyelitis Swelling Redness Deformity Impaired wound healing Systemic findings Pain at site of infection Generalised discomfort Septic arthritis Triad of fever, joint pain and restricted joint movement Usually monoarticular Most commonly affect joints, knees, followed by hips, wrists, shoulders and knees. Joints are swollen, red, warm and painful.