- ID: age, sex, hand dominance + occupation (if relevant)
- CC: (chief complaint)
- HPI: (ChLORIDE FPP)
- (C)Character: sharp or dull pain
- (L)Location: region (joint) of origin
- (O)Onset: sudden vs. gradual
- (R)Radiation
- (I)Intensity: how severe (scale 1-10), impact on ADLs (activities of daily living), is it getting better, worse or staying the same?
- (D)Duration: acute vs. chronic
- (E)Events associated: falls, morning stiffness, swelling, redness, joint clicking or locking, muscle cramps, muscle wasting, movement limitation, weakness, numbness or tingling, fever, chills, trauma (mechanism of injury), occupation activities, sports, repetitive movements
- (F)Frequency: intermittent vs. constant, have you ever had this pain before?
- (P)Palliative factors: is there anything that makes it better? (rest, activity, meds, heat, cold)
- (P)Provocative factors: is there anything that makes it worse? (rest, activity, etc.)
- PMHx: arthritis, gout, osteoporosis, connective tissue disease, past injuries, previous intervention in area of concern (surgery, injections, physiotherapy, etc.), other medical problems
- Meds: NSAIDs, acetaminophen, narcotics, steroids, immunosuppressants, ASA, anticoagulants, etc.
- Allergies: antibiotics, anti-inflammatories, anesthetics, etc.
- FHx: arthritis, osteoporosis, connective tissue disease, malignant hypothermia, etc.
- SHx: smoking, EtOH, occupation, activity level/exercise, use of mobility aids (cane, walker, wheelchair, etc.)
- O/E: VITALS, general appearance, ROS (cardiac, resp., neuro, etc.)
1.) Inspection: SEADS, gait, posture
- Swelling
- Erythema, Ecchymosis
- Atrophy
- Deformity
- Symmetry
2.) Palpation: TEST CA
- Tenderness
- Effusion
- Swelling
- Temperature
- Crepitus
- Atrophy
3.) Range of Motion (ROM)
- Active ROM: joint proximal to the joint being examined is immobilized while the pt. moves the joint in question
- Passive ROM: examiner performs the maneuvers
4.) Neurovascular Assessment: distal pulses & capillary refill, skin colour/temp., sensation & muscle power
5.) Special Tests: joint specific
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PEARL
: always examine the joint above & below the area of concern (referred pain) and compare each step of the exam with the contralateral joint/side |