History: A man in his early 40’s presents with 1 month of bilateral hand, wrist, elbow, shoulder, knee and ankle pain. He denies injury, fever or other symptoms. He denies recreational drugs but does smoke a little and drinks socially.
Exam: Vital signs are normal . Exam is normal except for swollen hands and knees, especially the left knee
Relevant Test Results:
- Labs: CBC and BPM normal. ESR 30, CRP 3
- Imaging: hands and L knee negative except for knee effusion
What is the most likely diagnosis?
- A) CHF
- B) RA
- C) GC
- D) SBE
- E) Allergy
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QUIZ ANSWER:
- A) CHF
- B) RA – CORRECT – knee tap showed 18,000 WBC and no crystals or bacteria.
- C) GC
- D) SBE
- E) Allergy
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CASE CONCLUSION: