Abstract
The clinical interview is a crucial component of patient assessment. Comprehensive and accurate history taking is an essential skill for students and doctors to learn and develop, and when performed correctly, it forms the most valuable element of the diagnostic process. This chapter outlines the art of teaching the patient’s history taking, different patterns of rheumatic diseases and diagnostic strategies of locomotor disorders. At the end, the reader will be able to differentiate the main patterns of musculoskeletal conditions and learn how to implement targeted questioning and clinical reasoning to analyse the patient’s symptoms and interpret the clinical findings. By learning how to differentiate inflammatory from mechanical joint pains, distinguish different causes of regional pain and characterize the commonest patterns of inflammatory as well as non-inflammatory arthritis and its differential diagnosis and how to set up an investigation plan, the reader will gain a comprehensive set of information, enabling him/her to achieve core competence in making diagnosis and treatment decisions. Both factual knowledge of medical conditions and practical experience of history taking are required to develop and refine this crucial skill that underpins clinical practice.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Smith R. Thoughts for new medical students at a new medical school. BMJ. 2003;327(7429):1430–3.
Woolf A, Kristina Åkesson K. Primer: history and examination in the assessment of musculoskeletal problems. Nat Clin Pract Rheumatol. 2008;4(1):26–32.
El Miedany Y. Adopting patient-centered care in standard practice: PROMs moving toward disease specific era. Clin Exp Rheumatol. 2014;32(suppl 85):S40–6.
European Action Towards Better Musculoskeletal Health. 2004. http://europa.eu.int/comm/health/ph_projects/2000/promotion/fp_promotion_2000_exs_15_en.pdf. Accessed 10 Sept 2017.
Bub B. The patient’s lament: hidden key to effective communication: how to recognise and transform. J Med Ethics Med Humanit. 2004;30:63–9.
European Action Towards Better Musculoskeletal Health. 2004. http://europa.eu.int/comm/health/ph_projects/2000/promotion/fp_promotion_2000_exs15_en.pdf. Accessed 13 Sept 2017.
Saleh K, et al. Development and evaluation of an integrated musculoskeletal disease course for medical students. J Bone Joint Surg Am. 2004;86-A:1653–8.
Badcock LJ, et al. Meeting the needs of increasing numbers of medical students—a best practice approach. Rheumatology (Oxford). 2006;45:799–803.
Bideau M, et al. Benefits of a programme taking advantage of patient-instructors to teach and assess musculoskeletal skills in medical students. Ann Rheum Dis. 2006;65:1626–30.
Hendry GD, et al. Patients teach students: partners in arthritis education. Med Educ. 1999;33:674–7.
Smith MD, et al. Evaluation of patient partners in the teaching of the musculoskeletal examination. J Rheumatol. 2000;27:1533–7.
Woolf AD, et al. Improving patient care by involving people with arthritis as educators of primary care physicians: the revised patient partner programme. Ann Rheum Dis. 2006;65(Suppl 2):620.
Woolf A, Åkesson K. Primer: history and examination in the assessment of musculoskeletal problems. Nat Clin Pract Rheumatol. 2008;4(1):28–33.
General Medical Council. Tomorrow’s doctors: recommendations on undergraduate medical education. London: Education committee, General Medical Council; 1993.
Walker D, Kay L. Musculoskeletal examination for medical students: the need to agree what we teach. Rheumatology. 2002;41:1221–3.
El Miedany Y, El Gaafary M, Youssef S, Almedany S, Palmer D. Using simulation in clinical education: psoriasis area and severity index (PASI) score assessment. Curr Rheumatol Rev. 2016;12(3):195–201.
Miller A, Mahtani KR, Waterfield MA, Timms A, Misbah SA, Luqmani RA. Is rheumatoid factor useful in primary care? A retrospective cross-sectional study. Clin Rheumatol. 2013;32(7):1089–93.
Kendall N, Burton K, Main C, Watson P. Tackling musculoskeletal problems: a guide for the clinic and workplace – identifying obstacles using the psychosocial flags framework. London: The Stationery Office (TSO); 2009.
Hill JC, Dunn KM, Lewis M, Mullis R, Main CJ, Foster NE, et al. A primary care back pain screening tool: identifying patient subgroups for initial treatment. Arthritis Rheum. 2008;59(5):632–41. http://onlinelibrary.wiley.com/doi/10.1002/art.23563/abstract
Centers for Disease Control Prevention (CDC). 2013. About the Behavioral Risk Factor Surveillance System (BRFSS). http://www.cdc.gov/brfss/about/about_brfss.htm. Accessed 16 Mar 2018.
Beland Y. Canadian community health survey–methodological overview. Health Rep. 2002;13(3):9–14.
Australian Bureau of Statistics. National health survey: user’s guide. 2009. http://www.abs.gov.au/ausstats/abs@.nsf/ProductsbyReleaseDate/2851D0FD9C52AB56CA257ACC000E3DE1?OpenDocument. Accessed 7 Jan 2018.
Busija L, Buchbinder R, Osborne RH. Quantifying the impact of transient joint symptoms, chronic joint symptoms, and arthritis: a population-based approach. Arthritis Care Res. 2009;61(10):1312–21.
Badley EM, Ansari H. Arthritis and arthritis-attributable activity limitations in the United States and Canada: a cross-border comparison. Arthritis Care Res (Hoboken). 2010;62(3):308–15.
Dominick KL, Golightly YM, Jackson GL. Arthritis prevalence and symptoms among US non-veterans, veterans, and veterans receiving Department of Veterans Affairs Healthcare. J Rheumatol. 2006;33(2):348–54.
Stang PE, Brandenburg NA, Lane MC, Merikangas KR, Von Korff MR, Kessler RC. Mental and physical comorbid conditions and days in role among persons with arthritis. Psychosom Med. 2006;68(1):152–8.
van’t Land H, Verdurmen J, Ten Have M, van Dorsselaer S, Beekman A, de Graaf R. The association between arthritis and psychiatric disorders; results from a longitudinal population-based study. J Psychosom Res. 2010;68(2):187–93.
Globe DR, Varma R, Torres M, Wu J, Klein R, Azen SP. Self-reported comorbidities and visual function in a population-based study: the Los Angeles Latino Eye Study. Arch Ophthalmol. 2005;123(6):815–21.
Ferucci ED, Schumacher MC, Lanier AP, Murtaugh MA, Edwards S, Helzer LJ, et al. Arthritis prevalence and associations in American Indian and Alaska native people. Arthritis Care Res. 2008;59(8):1128–36.
Busija L, Hollingsworth B, Buchbinder R, Osborne RH. Role of age, sex, and obesity in the higher prevalence of arthritis among lower socioeconomic groups: a population-based survey. Arthritis Rheum. 2007;57(4):553–61.
Lee S, Tsang A, Huang Y-Q, Zhang M-Y, Liu Z-R, He Y-L, et al. Arthritis and physical-mental comorbidity in metropolitan China. J Psychosom Res. 2007;63(1):1–7.
Vuković D, Bjegović V, Vuković G. Prevalence of chronic diseases according to socioeconomic status measured by wealth index: health survey in Serbia. Croat Med J. 2008;49(6):832–41.
Lima MG, De Azevedo Barros MB, César CLG, Goldbaum M, Carandina L, Ciconelli RM. Impact of chronic disease on quality of life among the elderly in the state of Sao Paulo, Brazil: a population-based study. Rev Panam Salud Publica. 2009;25(4):314–21.
Balluz LS, Okoro CA, Mokdad A. Association between selected unhealthy lifestyle factors, body mass index, and chronic health conditions among individuals 50 years of age or older, by race/ethnicity. Ethn Dis. 2008;18(4):450–7.
Ng TP, Niti M, Chiam PC, Kua EH. Prevalence and correlates of functional disability in multiethnic elderly Singaporeans. J Am Geriatr Soc. 2006;54(1):21–9.
Niti M, Ng TP, Kua EH, Ho RCM, Tan CH. Depression and chronic medical illnesses in Asian older adults: the role of subjective health and functional status. Int J Geriatr Psychiatry. 2007;22(11):1087–94.
Kriegsman DM, Penninx BW, van Eijk JT, Boeke AJ, Deeg DJ. Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients’ self-reports and on determinants of inaccuracy. J Clin Epidemiol. 1996;49(12):1407–17.
Singh JA. Discordance between self-report of physician diagnosis and administrative database diagnosis of arthritis and its predictors. J Rheumatol. 2009;36(9):2000–8.
Bombard JM, Powell KE, Martin LM, Helmick CG, Wilson WH. Validity and reliability of self-reported arthritis: Georgia senior centers, 2000–2001. Am J Prev Med. 2005;28(3):251–8.
March LM, Schwarz JM, Carfrae BH, Bagge E. Clinical validation of self-reported osteoarthritis. Osteoarthr Cartil. 1998;6(2):87–93.
Kvien TK, Glennas A, Knudsrod OG, Smedstad LM. The validity of self-reported diagnosis of rheumatoid arthritis: results from a population survey followed by clinical examinations. J Rheumatol. 1996;23(11):1866–71.
Palmer D, El Miedany Y. EROMIA in inflammatory arthritis: the next step in standard practice. Br J Nurs. 2013;9(1):42–6.
El Miedany Y, El Gaafary M, Youssef S, Bahlas S, Almedany S, Ahmed I, Palmer D. Toward electronic health recording: evaluation of electronic patient-reported outcome measures system for remote monitoring of early rheumatoid arthritis. J Rheumatol. 2016;43(12):2106–12.
El Miedany Y, El Gaafary M, El Aroussy N, Bahlas S, Hegazi M, Palmer D, Youssef S. Toward electronic health recording: evaluation of electronic patient reported outcome measures (e-PROMs) system for remote monitoring of early systemic lupus patients. Clin Rheumatol. 2017;36(11):2461–9.
Amarasingham R, Plantinga L, Diener-West M, Gaskin DJ, Powe NR. Clinical information technologies and inpatient outcomes: a multiple hospital study. Arch Intern Med. 2009;169:108–14.
Richter J, Chehab G, Schneider M. Electronic health records in rheumatology: emphasis on automated scoring and additional use. Clin Exp Rheumatol. 2016;34(Suppl. 101):S62–8.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
El Miedany, Y. (2019). The Art of Patient History Taking. In: Rheumatology Teaching. Springer, Cham. https://doi.org/10.1007/978-3-319-98213-7_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-98213-7_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-98212-0
Online ISBN: 978-3-319-98213-7
eBook Packages: MedicineMedicine (R0)