Red flags The following findings are of particular concern: Joint warmth, swelling, tenderness, and erythema Any extra-articular symptoms (eg, fever, rigors, rash, chills, skin plaques or nail pitting, mucosal ulcers, conjunctivitis, uveitis, murmur, purpura, weight loss) Interpretation of findings An important initial determination, based mainly on carefully done physical examination, is whether pain originates in the joints, in other adjacent structures (eg, bones, tendons, bursae, muscles), both (eg, as in gout), or other structures.