History of the present condition

History of the present condition

Insidious onset

Insidious onset means that the patient’s symptoms appear without any obvious cause. An example of this would be a degenerative condition such as osteoarthritis. These types of conditions often begin with a small amount of

stiffness and pain, which is characterised by exacerbation and remission but is, nonetheless, progressive.

Traumatic onset

Can the onset of symptoms be related to a particular injury? Identify if there was a definite cause for the patient’s symptoms. The mechanism of injury may be indicative of the structures damaged. For example, a valgus strain of the knee may stretch the medial collateral ligament of the knee, whereas forced rotation of the knee joint when in a semi-flexed weight-bearing position may tear the menisci.

Progression of the condition

Are the patient’s symptoms getting better or worse? Acute soft-tissue injuries normally undergo a period of inflammation and repair, and symptoms may subside rapidly within a few days or weeks. However, progressive arthritic diseases may have a history of exacerbation and remissions with a general increase in the severity or frequency of their symptoms, as the disease progresses. Progression of the condition may indicate how quickly the patient’s symptoms will subside.

Chronicity or age of the condition

How long has the patient experienced the symptoms? Is the condition acute or chronic? If the injury is chronic or has not resolved completely, it may indicate a number of different causes, such as mechanical instability from a ligament disruption, functional instability because of weakened muscles, loss of proprioception.

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