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E-triage Rheumatoid Arthritis Study in Early Arthritis (ERASE)
Please fill out the questions below
1. Do you have swelling in any of your joints
THAT OTHERS CAN SEE
?
Yes
No
2. Do you experience stiffness in your joints?
Yes
No
If yes, when is this most noticeable
on average
?
When I get out of bed
Afternoon
Evening
At Night
No consistent time
If yes, how long does it
usually
take from when you get out of bed until your joints are moving as well as they are going to move all day?
10 minutes or less
30 minutes
60 minutes or more
3. How long have you had your joint pain?
Weeks
Number of weeks:
Months
Number of months:
Years
Number of years:
4. Do Anti-Inflammitory drugs (e.g., Advil, Motrin, Ibuprofen, Arthrotec, Celebrex, Naproxen, Diclofenac) usually ease your pain and suffering?
Yes
No
Do not use these drugs
5. Do you suffer from any of the following:
Daily
Headaches
Yes
No
Irritable bowel syndrome
Yes
No
Chronic fatigue
Yes
No
Daily
jaw pain
Yes
No
