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Simone by Mind Map: Simone

1. Phys Exam

1.1. Reflexes

1.2. AROM/PROM

1.2.1. Accessory Glides

1.3. Pain/Tenderness on palpation?

1.4. Skin quality

1.5. Muscle Strength

1.5.1. Wasting = ^pressure on joints

1.6. Sensory deficits

1.7. Growth

1.7.1. Height

1.7.2. Body weight

1.8. Functional Tests

1.9. Joint stability/ ligament laxity

2. HOPC

2.1. Swollen, painfull knees

2.1.1. Limp developed

2.1.2. after netball

2.2. Swollen and sore wrists and hands

2.2.1. More redness and swelling in last 1/12

2.3. Eases

2.3.1. Swimming

2.4. Aggs

2.4.1. Netball

2.4.2. Little Athletics

3. PMHx

3.1. Baby

3.1.1. Hard to settle

3.1.2. cried

3.1.2.1. pain?

3.2. <6/12

3.2.1. red, painful knees

3.3. >12/12

3.3.1. Juvenile RA

3.3.1.1. Swollen joints (intermittent)

3.4. Toddler

3.4.1. Walking at 2years

3.5. visits Rheumatologist 6/12

3.6. Doing well

3.6.1. Intermittent stiffnes

3.6.2. swelling in knees

3.6.3. Tires easily

3.7. Medication

3.7.1. Folic acid (0.5mg/day)

3.7.2. Methotrexate (10mg/m^2 weekly

3.7.3. Naprosyn

3.7.3.1. Ineffective

3.8. Recent Cold

3.8.1. Agg?

3.9. Pain 3/10 when swelling

3.9.1. Increases with swelling increases

4. SHx

4.1. 9 y.o

4.2. Year 4

4.3. Family MHx

4.3.1. Great Aunt

4.3.1.1. RA

4.3.1.2. SLE

4.3.1.3. Wheelchair

4.3.1.3.1. Inability to WB

4.3.1.3.2. Waiting for KR

4.4. Sports

4.4.1. Netball

4.4.1.1. Team player

4.4.2. Little Aths

4.4.3. Swimming classes/Hydrotherapy

4.5. Mother

4.5.1. Reservations about amount of sports

4.6. 2 siblings

4.7. Close circle of friends

4.8. Misses school

4.8.1. Teacher gives homework

5. Info Required

5.1. Siblings and Juvenile RA

5.2. Transport to school?

5.3. Load at school/sport/extracurricular

5.3.1. Level of sport

5.4. Eases for stiffness/pain?

5.4.1. Irritability?

5.4.1.1. VAS Pain levels

5.5. Recent Imaging?

5.6. Visit of Rheumatologist

5.6.1. Medication change?

5.6.2. Other health professionals?

5.7. Number of Joints affected

6. Phys Exam Results

6.1. X-Ray hand/wrist/ankle/knees

6.1.1. ISQ = Unchangesd

6.2. Full blood exam

6.3. Height = 133cm

6.4. Questionnaires

6.4.1. 5/24 (HAQ disability index)

6.5. Functional Tests

6.5.1. limp when walking

6.5.2. R knee sore in FWB

6.6. AROM

6.6.1. Full Knee AROM

6.6.2. Full Wrist AROM

6.7. No joint laxity

6.8. Palpation

6.8.1. Wrist tenderness

6.8.2. Knee tenderness

6.8.2.1. Warmth

6.8.2.1.1. L>R

6.9. Muscle Strength

6.9.1. Good Grip Strength

6.9.2. Decreased R knee extension