Key points of rheumatic disease consultation

  Generally demonstrate progression of symptoms in chronological order Joints: manifestations (redness, swelling, pain, limitation of movement), location (single/low/multiple, peripheral/medial), triggers (medications, infection, diet, activity, trauma), course (episodic, progressive) Systemic symptoms: fever, wasting, malaise. (Suggestions: systemic disease activity, vasculitis, paraneoplastic syndrome) Skin: zygomatic erythema, photosensitivity, alopecia, hard fingers, Raynaud’s phenomenon, extremity ulcers, psoriasis, skin/mucosal ulcers, purpura, nodules, genital lesions and dry mouth and eye symptoms  Cardiopulmonary: dyspnea, cough, hemoptysis, pleuritic or pericardial chest pain, swelling, decreased exercise tolerance, PE, pulmonary hypertension manifestations Gastrointestinal: reflux, dysphagia, abdominal pain, diarrhea, blood in stool, jaundice Renal: proteinuria, stones, nocturia, oliguria Blood: WBC ↓, Hb ↓, PLT ↓, miscarriage, bone pain, unexplained DVT or PE, serologic abnormalities Neurologic: polyneurologic/multiple single Neurologic/peripheral nerve disease, psychosis, cognitive impairment, headache, vision, muscle weakness, TIA/stroke, convulsions Endocrine: hyper/hypothyroidism, abnormal adrenal axis manifestations Past: tuberculosis, hepatitis B/C, history of medication use