Important features on history, and predisposition to inflammatory rheumatological diseases

A person’s predisposition to specific inflammatory rheumatological diseases might be influenced by their:

  • constitutional features
    • age and gender (eg gout is unlikely in premenopausal females)
    • family history (eg the various forms of spondyloarthritis share a genetic link with human leucocyte antigen B27 [HLA-B27])
    • ethnicity (eg systemic lupus erythematosus [SLE] is more common in Asian, Aboriginal and Torres Strait Islander peoples, Polynesians and Polynesian New Zealanders; gout is more common in Polynesians and Polynesian New Zealanders)
  • socioeconomic factors
    • body mass index (BMI) (eg obesity increases the risk of osteoarthritis and rheumatological diseases)
    • tobacco smoking (eg rheumatoid arthritis is more common in people who smoke)
    • alcohol consumption (eg gout is more common in people with high alcohol consumption)
    • low socioeconomic status and overcrowding (eg acute rheumatic fever has a high prevalence in rural and remote communities of Aboriginal and Torres Strait Islander peoples)
    • recent travel (eg travel-related infections such as viral arthritis including Ross River fever or reactive arthritis associated with enteric infection)
    • sexual history (eg reactive arthritis associated with sexually acquired infections)
  • medications
    • aromatase inhibitors are associated with arthralgias
    • statins are associated with myalgias.