Medical history is an important tool in diagnosing RA. When your doctor takes your medical history, he or she will ask many questions about your present symptoms and past medical problems, as well as your lifestyle, medicine use, and family history.
Your doctor is like a detective trying to solve a crime. He or she will use what they learn along with findings from a thorough physical exam and laboratory and other tests to piece together what may be happening to cause your symptoms. You can provide valuable assistance in solving the case and coming up with a diagnosis by making sure you are providing accurate information during the medical history.
What questions to expect during medical history
- Can you describe your symptoms?
- When did they start?
- When is your joint pain most severe, in the morning or later in the day?
- Does exercise or activity help?
- Do your symptoms affect your ability to sleep?
- Are you stiff in the morning?
- Has your weight changed?
- Are you ever feverish?
- Do you currently have any health problems and what health problems have you had in the past? (Examples include heart disease, hypertension, diabetes, infections, stomach problems, rashes, fever, allergies, other types of arthritis)
- Has anyone in your family ever had arthritis?
- What medications do you currently take (including prescription and other types of medications
- How often do you take these?
- What medications are you currently taking for your joint problems, how long have you been taking them, how effective are they, and have they caused any side effects?
- Describe your lifestyle, including what you do for exercise.
- Have your symptoms affected your ability to engage in normal activities?
- What are your eating habits? Do you have food allergies?
- Do you consume alcohol (how many drinks per week) or do you use recreational drugs (what kinds)?
- Are you a smoker? If so, how many packs per week
- Have you already had any tests or evaluations of your current symptoms?
- Have you been exposed to a hazardous substance in the workplace or home?
What kinds of questions will my doctor ask during the medical history?
When you arrive for your first visit with the rheumatologist, you will probably be given a form to fill out detailing your medical history and asking you about any past or current medical problems and medications, vitamins, or supplements you currently take.
When your doctor talks with you, he or she will ask further questions about your medical history, what medications you are currently taking, and your family history of health problems. Be prepared to report any health problems you currently have or have had in the past, including heart disease, hypertension, diabetes, allergies, rashes, infections, mental health problems, and other types of arthritis. Your doctor will be looking for evidence of other disorders, especially other autoimmune conditions that may explain your symptoms, such as psoriasis, inflammatory bowel disease, or systemic lupus erythematosus. Be as complete as you can when you list medications (both prescription and over-the-counter), vitamins, and supplements you currently take.1
Since RA symptoms are the reason for your visit, your doctor will spend a long time inquiring about your symptoms. He or she will have you describe the symptoms you are experiencing. For instance, your doctor will want to know about the nature of your pain, including whether it is intense or dull, when it began and how long it has lasted, the location of your pain, whether it is limited to one place or more general, whether it comes and goes or is more constant, and whether there is a pattern to the involved joints (joints on both sides of the body or only on a single side). Your doctor will also want to know about other symptoms, including fatigue, difficulty sleeping, inflammation in different areas of your body, and mobility problems. The medical history will also include questions about the extent to which your symptoms impact your lifestyle, you everyday functioning, and your ability to work.1
Be prepared to talk about your symptoms
- What type of pain do you experience? Is it dull or intense, localized or general? How long does it last and when is it most severe (in the morning or evening, after exercise, when you sleep)?
- Which joints are affected? The neck, back, arms, wrists, fingers, shoulders, hips, knees, feet?
- Are your joints swollen, inflamed, or warm?
- Is there a pattern to your joint pain (does the pain occur on both sides of the body or just one)?
- Are you experiencing fatigue or weakness?
- Are you having difficulty sleeping and, if so, what is the nature of your difficulty (difficulty getting to sleep, waking during the night)
- Are you tired during the day?
- Are you having difficulty walking and getting around? At times, do you feel like your body has stiffened or “jelled”? When does this occur (in the morning, after sitting)?
- How long or how far can you walk before hurting or getting tired?
- Can you climb stairs?
- Do you have any difficulty getting up from any of the following: an armchair, armless chair, bed, floor, toilet, bathtub, out of a car?
- How much do your symptoms interfere with your lifestyle or ability to engage in normal activities?
- Activities may include grooming, brushing hair, shaving, clipping toenails or finger nails, tying shoes, opening jars, buttoning clothing, carrying groceries, using the toilet, reaching for books or other items on shelves.
- Do your symptoms affect your ability to work?
- Do your symptoms affect your ability to engage in sports or to exercise?
Things to think about before your doctor visit
Because your doctor will want to get a complete picture of how your symptoms are affecting you, before you show up for this first visit, gather your thoughts and collect information about all of the topics mentioned here. Make sure that you put together a list of the medications (including prescription and over-the-counter), vitamins, and supplements you currently take. Also, ask you family members about whether you have had any relatives with arthritis and what kind of arthritis it was (is).
It also helps to bring some paper and a pencil or pen to take notes. Sometimes during a doctor’s visit—because of the stress involved—it is difficult to absorb everything you discuss, as well as any recommendations you doctor may make. In addition to bringing a writing implement and paper, it may also be helpful (if you are comfortable with this) to have another set of ears in the room, such as a friend or family member who can listen and take notes.