Key elements of the history when evaluating a child with joint pain or swelling

Category	Details
Number of joints involved and their location	Single joint Multiple joints
Characteristics	Severity and quality of pain Frequency of pain Duration of the episode Presence of swelling, erythema, other discoloration Diurnal variation Nocturnal pain Interference with normal activities, including sleep Inability to bear weight Progression over time
Precipitating factors	Trauma Antecedent illness Periods of inactivity Increased physical activity
Presence and pattern of associated symptoms	Fever Rash Weight loss Abdominal pain Diarrhea Eye symptoms Other
Pattern of symptoms	Acute versus chronic Morning stiffness Migratory pain Recurrent episodes of joint pain and swelling

Courtesy of Yukiko Kimura, MD and Taunton R Southwood, MD, FRACP, FRCPA, FRCP, FRCPCH.

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