Rheumatology Typing Practice

This page sets up the trainer with the rheumatology pack: clinic and consult note lines, joint injection notes, imaging, ultrasound and pathology reads, and DMARDs and biologics with their doses. Choose Rheumatology in the Specialty menu or open a preset below to mix the pack into the general clinical corpus.

Open the trainer with the Rheumatology pack

Clinic joint exam and plan Serologies and scores Injections, imaging and path reads

Preset links open the trainer with those settings already applied; you can change them afterward.

What rheumatology notes are made of

Most rheumatology typing happens in clinic: new consults for a positive ANA, joint pain, a high CK or gout, return visits for patients on DMARDs or biologics, and infusion notes. Inpatient consults cover the hot joint, suspected vasculitis, lupus flares, myositis and macrophage activation syndrome. Short procedure notes for joint aspirations and injections are written at almost every clinic session, with the same structure each time: consent, approach, needle, steroid dose and aftercare.

The history separates inflammatory from mechanical pain and records how long morning stiffness lasts. The exam lists synovitis by joint group and 28-joint tender and swollen counts. The results section is dense with antibody names: ANA titer and pattern, anti-dsDNA with complements, anti-CCP, ANCA subtypes and myositis panels. Plans are measured against a disease activity score such as CDAI, DAS28 or SLEDAI-2K, and joint and drug abbreviations (MCP, PIP, MTP, MTX, HCQ, TNFi, ULT) appear in nearly every line.

What the rheumatology pack adds

The pack adds 950 items and gives extra weight to 322 items already in the general corpus, which had most of the core diagnoses, DMARDs and serologies. Its 483 note phrases follow a clinic note from referral HPI through exam, results, assessment, plan, counseling and procedure notes, with scores that match their activity thresholds. The 101 report lines cover hand, foot and spine radiographs, musculoskeletal and vascular ultrasound, SI joint MRI, HRCT patterns in connective tissue lung disease, DXA, capillaroscopy, and biopsy reads.

• 28-joint count with 8 tender and 5 swollen joints
• Seropositive, erosive rheumatoid arthritis with moderate disease activity by CDAI 18
• ANA positive at 1:640 in a homogeneous pattern, anti-dsDNA 212, C3 62, C4 8
• Right second metacarpophalangeal joint injected with 10 mg triamcinolone acetonide using a 27-gauge needle
• Double contour sign over the femoral trochlear cartilage of both knees, consistent with urate deposition
• Start allopurinol 100 mg daily and increase by 100 mg every 2 to 4 weeks to serum urate below 6

Dosing covers 83 drugs, with schedules written out in full: methotrexate 15 mg po once weekly, infliximab 3 mg/kg iv at weeks 0, 2, and 6 then every 8 weeks, and tocilizumab 162 mg subcutaneously weekly. Newer drugs such as anifrolumab, voclosporin and avacopan are in the drug lists.

How to practice

With Rheumatology selected, roughly half of what you type comes from the pack and the rest from the general corpus, and the category chips filter both. For a clinic day, turn on Note Phrases, Symptoms & Signs, Anatomy and the generic drug chip. For injection notes and reads, use Radiology & Path Findings with Procedures and Anatomy.

The Abbreviations toggle flips each pack phrase between spelled-out and shorthand forms: "Continue methotrexate 20 mg by mouth once weekly with folic acid 1 mg daily" becomes "Continue MTX 20 mg PO once weekly w/ folic acid 1 mg daily". Rheumatologists chart with the short joint and drug names, so keep it on if you scribe in a rheumatology clinic. Block mode holds you at each mistake until it is fixed, useful for antibody names and titers such as 1:640. Cascade lets errors go by so you can practice keeping up with a visit. Realistic frequency favors common diagnoses; Even brings rare antibodies and syndromes forward. Five to ten minutes on most days is a good rhythm. AI Mode works with any of these settings, and there is no account: progress stays in your browser.