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Rheumatology Assessment

Use when asked to administer, score, or explain a Rheumatology Assessment — disease activity evaluation using DAS28 — grounded in FormExamples/form-examples.

Rheumatological evaluation using the DAS28 (Disease Activity Score in 28 joints), with joint assessment, laboratory results, and extra-articular features.

Scoring

Instrument: DAS28 — a continuous score.

  • < 2.6 — remission.
  • 2.6–3.2 — low activity.
  • 3.2–5.1 — moderate activity.
  • > 5.1 — high activity.

What it covers

Demographics; chief complaint; joint assessment; disease history; extra-articular features; laboratory results; current medications; allergies; functional assessment; and comorbidities with social history.

Common pitfalls

  • Scoring joints inconsistently between visits — DAS28 depends on a standardized joint examination (the same 28 joints, consistently assessed for tenderness and swelling); inconsistent technique between assessors undermines its value for tracking disease activity over time.
  • Missing extra-articular features — several rheumatological conditions have significant extra-articular manifestations (eye, skin, lung, cardiovascular); a joint-only assessment can miss these entirely.
  • Treating DAS28 remission as meaning treatment can stop — clinical decisions about tapering or stopping treatment require more context (sustained remission duration, imaging, risk of flare) than a single DAS28 reading.

Learn more

View rheumatology-assessment/SKILL.md on GitHub