Symptom: Redness Around Joint(s)

Initial Grading Reminder

CTCAE Criteria for joint erythema:

Grade 1: Mild pain with inflammation, erythema, or joint swelling
Grade 2: Moderate pain associated with signs of inflammation, erythema, or joint swelling; limiting instrumental ADLs
Grade 3: Severe pain associated with signs of inflammation, erythema, or joint swelling; irreversible joint damage; disabling; 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? Have you had joint redness in the past?

Grade the symptom

Ask the patient:

How red is your joint? Is it stiff? Is it swollen? Is it hot? Any fever and or chills? Are you able to do your normal activities?

Patient Query Regarding Other Symptoms/Red Flags

Ask the patient:

Have you fallen? Do you have any joints 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

    Patients with new-onset moderate or worse (or worsening) joint erythema 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 redness around the joint?