- Joint distribution
- Extra inflammatory features
- Anatomic site(s), activity vs damage
"Make up your mind after H&P, use labs to confirm your diagnosis"
- "Innocent bystanders"
- ANA (if positive once don't reorder)
- Most extractable nuclear antigens
- MRI: "STIR sequence" if investigating spondylitis
When to refer to rheumatology
- Patients with chronic back pain (if considering ankylosing spondylitis)
- >3 months of continuous pain/stiffness
- Onset of symptoms less than 45 years
- Abnormal imaging of SI joints or HLA-B27 or EAF
- Refractory gout