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DAS Score!

Having visited my Rheumatologist for my second appointment in 5 months!

He Carried out my DAS Score which was 3.5 first visit now 3.3 this visit...

I am a bit confused by him very softly touching my finger joints knees and elbows how he can tell my decease activity!!! Am I supposed to yell out in pain or can he tell by just the feel of the joint?

My Joints ache almost all the time but not to the point where it would hurt when he touches them.....

Please help as I'm very confused!!!

6 Replies

Forgot to say even though my score has gone down slightly he has increased my Methotrexate from 15mg to 20mg!


It will be obvious to him even if he doesn't appear to be pressing hard. Your DAS score may have reduced due to something simple like you not scoring yourself quite as high on pain (on the 0-10 or 0-100 scale your Rheumy asks you to determine how much pain you're in). He's obviously of the opinion you're in need of an increase in MTX, he's picked up on something either from the DAS examination of your bloods or even something you've said if he's the kind of Rheumy who listens, I take it you told him your joints ache? Despite swollen ankles & feet at my last appointment my DAS score was lower than my previous one & my MTX dose increased & my etoricoxib to every day. I wouldn't be too concerned or pay too much heed to your DAS score as it stands now, you're still in the low disease activity range. :)

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You may find the NRAS booklet "know your DAS" useful and you can get your free copy via or by calling 0845 458 3969 or emailing

One thing I always say to patient groups that I visit is "Don't put on a brave face for your rheumatologist or your nurse. There are no prizes for being the "best patient" of the if it hurts tell them loud and clear. As fantastic as some consultants and nurses are they don't have super powers to read minds."

So yes if yelling out in pain is what you want to do when getting your DAS taken then most definitely do so.

While they can feel the "sponginess" of swelling during the examination they cannot feel the level of pain that might be causing. You can have pain without swelling and vice versa swelling without pain.

There is also a useful video clip on the NRAS website

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Thank you Claire


The consultants can tell quite a bit from the feel and look of the joints - so if you have "boggy" joints, redness or swelling that is recognised by the DAS scoring. And if your consultant has a lot of experience they can probably tell a lot from how you walk in the room, and hold yourself as you sit down! Once time my consultant said that it was obviously things were starting to improve as I'd crossed my legs - and it was true. Up till then my knees had hurt so much there was no way I'd cross them!

And the calculation also takes in blood tests results as well as how you are feeling - it's really worth reading the NRAS information as the more you know yourself the easier you will find it to talk to the consulatant, and ask questions.


I'm dubious about how useful DAS is. On a couple of occasions rheumy nearly took me off a med that was working because i complained too much. I'm inclined to refer to the NRAS info - the last time I worked it out for myself before going to the hospital. Its worth being on top of what is going on!


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