Clinical exam · History taking and the interview
Analysing a symptom: onset, site, character, radiation and more !
- Topic
Every symptom is described with the same attributes so another clinician understands exactly what the patient feels.
Updated 2026-11-01
What it is
Analysing a symptom means describing it with a fixed set of attributes: how it began, where it is, what it is like, where it spreads, how bad it is, how long it lasts, what changes it and what comes with it. Pain is the classic example, but the same method works for cough, breathlessness or dizziness. A well-characterised symptom greatly shortens the list of possible diagnoses.
Key facts
- The patient points with one finger: a precise point suggests somatic pain; a diffuse area, visceral pain.
- Referred pain is felt away from the affected organ, in the area that shares its nerve supply (for example the shoulder in diaphragmatic irritation).
- Current severity is compared with previous episodes and with the onset.
- Ask about impact: sleep, work, appetite, daily activities.
Step by step
- Onset: 'When did it start, and how: suddenly or gradually?'
- Site: 'Point with one finger to where it hurts.'
- Character: 'What is the pain like: a weight, burning, stabbing, cramping?'
- Radiation: 'Does the pain move anywhere else?'
- Severity: 'From 0 to 10, where 10 is the worst pain imaginable, how bad is it?'
- Timing: 'Is it constant or does it come and go? How long does each episode last?'
- Modifiers: 'What makes it worse or better: eating, moving, breathing, resting?'
- Associated: 'Have you had fever, nausea, vomiting, sweating or shortness of breath with it?'
Test yourself
Think of the answer, then tap the question to see it.
Which attributes are explored when analysing pain?
Onset, site, character, radiation, severity, timing, aggravating or relieving factors and associated symptoms.
What does pain pointed to with one finger suggest, compared with diffuse pain?
Well-localised pain suggests a somatic source (wall, parietal peritoneum); diffuse, poorly localised pain is typical of visceral pain.
What is referred pain?
Pain felt in an area away from the diseased organ that shares its segmental nerve supply, for example shoulder pain from irritation of the diaphragm.
Which features of chest pain point to myocardial ischaemia?
Pressing retrosternal pain, triggered by exertion or stress, radiating to the left arm, neck or jaw, with sweating or breathlessness.
Related
- Chief complaint and history of present illness
- Pain assessment and pain scales
- Chest pain: ischemic, pericardial, pleural and other patterns
- Acute abdomen and peritoneal irritation
- Respiratory symptoms: cough, sputum, hemoptysis and dyspnea
Related conditions
Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis.
Sources: 12.3 Collection of Assessment Data - Fundamentals of Nursing | OpenStax (OpenStax, Rice University, 2024).
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Representative model, for educational purposes only.