Problem Process Common Pattern of Onset Progression Associated Symptoms

Location Spread and Duration

Swelling Stiffness Generalized
Symptoms
Rheumatoid Chronic Hands (PIP and Symmetrically Usually Often chronic, with Frequent swelling Prominent Weakness,
Arthritis inflammation of MCP) additive: insidious remissions and of synovial tissue fatigue, weight
synovial progresses exacerbations in joints or tendon Often for an hour loss, and low fever
membranes Feet (MTP to other joints sheaths or more in the are common
with secondary Joints) while morning and after
erosion of persisting in the Subcutaneous inactivity
adjacent Wrists initial ones nodules
cartilage and
bone, and damage Knees
to
ligaments and Elbows
tendons
Ankles

Osteoarthritis Degeneration and Knees Additive; Usually Slowly Small effusions in Frequent but brief Usually absent
progressive loss of however, only insidious progressive, the joints may be (usually 510
cartilage within the Hips one joint may be with temporary present, min), in the
joints, damage to involved. exacerbations especially in morning and after
underlying bone, Hands (DIP, after periods of the knees; also inactivity
and formation of sometimes PIP) overuse bony
new bone at the enlargement.
margins of the Cervical spine
cartilage
Lumbar spine

Wrists (first
carpometacarpal
joint)

Joints previously
injured or diseased
Gouty Arthritis An inflammatory Base of the big toe Early attacks Sudden, often: Occasional Present, within Not evident Fever may be
Acute reaction to (1st MTP) are usually isolated attacks and around present
Gout microcrystals of confined to one At night lasting days the involved joint
sodium urate Instep or dorsum joint. up to 2 weeks;
of feet After injury they may get more
frequent and
ankles, After surgery severe, with
knees, and elbows persisting
Fasting symptoms

Ecessive
food or alcohol
intake

Chronic Multiple local Feet Additive, not so Gradual Chronic symptoms Present, as tophi, Present Possibly fever;
Tophac accumulations of symmetric as development with acute in joints, bursae, patient may also
eous sodium urate in Ankles rheumatoid of chronicity exacerbations and subcutaneous develop symptoms
Gout the joints and arthritis with repeated tissues of renal failure and
other tissues Wrists attacks renal stones.
(tophi), with
or without Fingers
inflammation
Elbows