What six questions to ask when obtaining a history from a patient with chronic monoarticular arthritis

What six questions to ask when obtaining a history from a patient with chronic monoarticular arthritis?

a) Is there a history of tuberculosis or a positive tuberculin skin test/interferon-gamma release assay? Consider mycobacterial disease.

b) Is the patient a farmer, gardener, or floral worker? Consider sporotrichosis.

c) If the knee is involved, has the joint been damaged in the past? Does it ever “lock” in flexion? Consider internal derangement and osteoarthritis.

d) Has the patient ever experienced previous acute attacks of joint pain and swelling that resolved spontaneously in any joint? Consider inflammatory joint syndromes.

e) Has the patient recently been treated with a prolonged course of corticosteroids for any reason? Consider osteonecrosis of bone.

f) Has the patient had symptoms such as a skin rash, low back pain, diarrhea, urethritis, or uveitis? Consider spondyloarthritis.

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