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Kim's diagnosis

The following features suggest that Kim may have an inflammatory arthritis, which will need assessment and treatment in secondary care:

  • acute onset
  • family history of psoriasis
  • smoking
  • inability to form a tight fist
  • painful squeeze test
  • knee effusion.
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GP talking to patient

Weighing up the likely causes of a patient's pain is key to deciding on an initial management plan and in considering whether to refer for specialist opinion.

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