If the pattern of symptoms (e.g. history of swelling, morning stiffness, response to activity and involvement of several joints) suggests an inflammatory disorder, a family history and symptoms of extra-articular features (Table 8.5) should be sought. If leg or foot pain is diffuse or poorly localised by the patient, referred pain, for example owing to lumbar nerve root pathology, should be considered. Pain in the knee is usually well localised while hip pain may be reported in the groin, anterior thigh or knee. The impact of lower limb symptoms on normal daily activities, i.e. the extent of disability, should be documented (Table 8.11).
TABLE 8.11 Activities of daily living involving the lower limb
• Walking, climbing stairs
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