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Polyarthralgia

HISTORY:

Diffuse joint pain for  

Affected joints:   

Onset:  

Severity: ,  / 10

Type: 

Pattern: , worse during the 

Worsening factors: 

Treatments tried: , 









, up to °, over  









































Other elements:



EXAM:

General appearance: 

Vital signs: , BP , HR , RR , SpO2  %, Temp °

Eyes: -R: , -L: , 

Throat: 

Neck: 

Heart: , 

Lungs: , 

Abdomen: ,  , , 

Skin: 

Extremities: , , cap refill , pulses , 

Musculoskeletal: joints  , 

Cervical spine:  on , range of motion 

Shoulder: :  on , range of motion 

Elbow: :  on , range of motion 

Wrist: :  on , range of motion 

Hand: :  on , range of motion 

Lumbar spine:  on , range of motion 

Hip: :  on , range of motion 

Knee: :  on , range of motion 

Ankle: :  on , range of motion 

Foot: :  on , range of motion 

Neurologic: cranial nerves , strength , sensation , reflexes , cerebellar function , gait 



ASSESSMENT:

 

DDx: 



PLAN:

- Blood work: , , , , , , , , 

- X-ray of affected joints

- MRI of affected joints

- Encourage regular exercise

- Heat or cold therapy

- 

- 

- 

- 

- Physical therapy

- Occupational therapy

- Referral to rheumatologist

- Follow-up in  

- Return if pain worsens, if new symptoms develop such as fever or unexplained weight loss, or if symptoms do not improve with treatment