Rheumatological diseases include conditions that affect only limited regions of the locomotor system and also conditions that can have widespread systemic effects. The rheumatological history must reflect both of these aspects. The main symptoms of joint disease are pain, stiffness, swelling and deformity. It is also important to enquire about functional impairment and resultant disability. Systemic diseases can be associated with non-specific symptoms, such as fever, anorexia and weight loss. A careful systems review is important in eliciting specific symptoms.
Jane E Dacre FRCP is Professor of Medical Education and Director of the Division of Medical Education at UCL Medical School, London, UK, and Consultant Physician and Rheumatologist at the Whittington Hospital, London, UK. Competing interests: none declared
Jennifer G Worrall FRCP is Consultant Rheumatologist at the Whittington Hospital, London, UK. Competing interests: none declared
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