“2016 Novel Guideline” Approaching Towards Joint Pain

In the history of the patient with joint pain we have to know whether or not the joint pain is mechanical or inflammatory, acute or chronic and traumatic or non-traumatic. In the physical examination of the patient, it should be determined whether or not the origin of the pain is articular, peri-articular, extra-articular or referral. In case of articular pain, the pain can be due to Arthralgia, Arthrosis (osteoarthritis) or Arthritis. For the detection of arthritis, we need at least two points from below items along with tenderness of joint; swelling: 2 points, warmth: 1 point, limitation of motion: 1 point and redness: 1 point. We have to know three data regarding patient including: Age, Sex and Race. We have to evaluate ten key items regarding arthritis including: 1- The confirmation of arthritis 2- Acute versus chronicity 3- Mono, oligo or polyarticular typing 4- Symmetric versus asymmetric typing 5- Migratory, additive or synchronized pattern 6- Small versus large joint involvement 7- Upper limb versus lower limb involvement 8- The presence of axial involvement 9- The presence of muscle involvement 10- The presence of extra musculo-skeletal (systemic) involvement. For approaching towards joint pain we follow two rules called “The Rules of Ninety five percent”. The first rule represents us that, the role of history, physical examination and Para-clinics in diagnosis is 60%, 30% and 5% respectively. The second rule shows us that in the medicine the 95% is actually equal to 100%. These above two rules are accurate in 95% of the cases and this was “2016 Novel Guideline” approaching towards joint pain.