HPI vs ROS
The Associated signs/symptoms in the HPI are what the patient voluntarily reports.
The ROS is an inventory of systems where the provider asks questions of the patient regarding possible symptoms or history of issues by system.
So if the patient comes in and relates: I fell off my bicycle yesterday and landed on my left wrist. I put ice on it overnight, but it's still swollen. I can't bend it and my fingers are tingly.
Here you have context (fell off bicycle), duration (yesterday), location (left wrist), modifying factors (ice overnight), associated signs (swelling, tingling and decreased ROM)
However ... you wouldn't NEED all those signs/symptoms ... you have 4 elements of HPI before you even get to the swelling, etc. So you COULD use those elements of the HPI as ROS (MS and neuro for the tingling).
The provider would have also asked questions in a review of systems (or had the patient complete a questionaire) ... so may have been able to report: no fractures, no fever, positive for tingling and swelling of LLE, no other problems with ROM or sensation.
Hope that helps.
F Tessa Bartels, CPC, CEMC