Symptom: Pain, Joint

Initial Grading Reminder

CTCAE Criteria for Grading Joint Pain:

Grade 1: Mild pain
Grade 2: Moderate pain; limiting instrumental ADLs
Grade 3: Severe pain; limiting self-care ADLs

Assessment and Grading

Characterize the symptom (onset, pace)

Ask the patient:

Is this a new or worsening symptom? When did it start or get worse? Has it developed gradually or suddenly? Do you typically have pain there?

Grade the symptom

Ask the patient:

How painful is your joint? Is it stiff? Is it preventing you from your normal daily activity?

Patient Query Regarding Other Symptoms/Red Flags

Ask the patient:

Have you fallen? Do you have a joint that you can’t put weight on?

Patient Factors to Consider That Affect the Approach to Intervention

Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?

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    Suggested Intervention

    Newly emergent or worsening moderate joint pain should be seen.

    Patients with any of the red-flag symptoms should be seen immediately.

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    Nursing Assessment of Potential Causes

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    Differential Diagnosis

    What do you suspect is the cause of the joint pain?