Knee pain SOCRATES Associated features Fever Rash Chills Wounds Fatigue Red eye Eye pain Weakness Skin heat Weight loss Joint locking Morning stiffness Walking issues Altered bowel habits Joint redness Knee stiffness Knee instability Knee clinking Nail changes Hand changes Medications Past medical history Surgical history Trauma history Family history Social history Diet Exercise Alcohol history Smoking history Recreational drug history Mobility Personal activities of daily living. Differentials RA Insidious onset Rash Red eye Peripheral before axial joints. Polyarticular Knee redness Knee stiffness Joint symptoms appear as: Hot Swollen Painful joints MCP, PIP, MTP and Wrists DIP sparing Symmetrical Morning stiffness -> more than 30 minutes Knee -> shoulder -> elbow -> hip Functional loss from the synovial inflammation Extra-articular manifestations: Constitutional symptoms Cardiac diseases: AF, CAD, HF Dyspnoea: interstitial pneumonitis, pulmonary nodules, pleurisy Eye pain and redness -> keratitis, scleritis, episcleritis Poor vision -> keratoconjunctivitis Rheumatoid nodules on extensor surfaces -> painless Skin changes from vasculitis Osteoporosis Asymptomatic until fracture Fragility fractures Vertebral fractures are the MOST common Fall and pop/sharp midline back pain Flank radiation Hip fractures are also common Gout Skin heat Redness Knee deformity OA Weakness Knee stiffness PA Knee redness Nail changes -> pitting, onycholysis Knee stiffness Rash Uveitis Enthesitis Dactylitis Baker’s cyst Popliteal bulge Injury Wounds Instability Septic arthritis Intense and sharp pain Semi-acute onset Fever/febrile Warmth and swelling Chills Skin heat Knee redness Joint redness Ask about animal bites, accidents and traumas Limited function to pain. Crystal arthropathies Swelling Skin heat Knee redness