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Student Education

10 minute consultation: Polyarthralgia

BMJ 2003; 326 doi: (Published 01 June 2003) Cite this as: BMJ 2003;326:0306185
  1. Jo Samanta clinical, research assistant1
  1. 1Julia Kendall, general practice clinical assistant, Ash Samanta, consultant rheumatologist, Department of Rheumatology, Leicester Royal Infirmary, Leicester LE1 5WW

A 45 year old woman says she has had joint pains in her hands, knees, and hips for three months. Her symptoms have progressively worsened. Jo Samanta, Julia Kendall and Ash Samanta take you through a common condition in primary care patients with painful joints

What issues you should cover

Assessment--Is her joint pain simple arthralgia, degenerative joint disease, or an inflammatory arthropathy, or is it secondary to some other cause?

History--Ask whether she has had any swelling around the joints, morning stiffness, nocturnal pain or pain at rest, or recent viral or throat infection. Check for systemic features such as fever, weight loss, or fatigue. She may have bowel or bladder symptoms, and her eyes or skin may be affected. Is there a family history of rheumatoid arthritis? Other features may be prolonged repetitive use of hands; mood changes, altered sleep pattern, or lack of energy; and use of …

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