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Ace the Case: A 72-Year-Old Woman With Several Weeks of Pain and Stiffness in Her Shoulders, Neck, and Pelvic Region
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A 72-year-old female is referred by her family practitioner due to several weeks of pain and stiffness in her shoulders, neck, and pelvic region. She self-medicated with acetaminophen and NSAIDs without benefit. Fatigue has become progressively worse and she is no longer able to shop and care for her home. Her past history is remarkable for hypothyroidism, which has been effectively treated for 22 years, osteoarthritis affecting her hands and neck, and irritable bowel syndrome.
Physical examination reveals normal vital signs, including upper extremity blood pressures of 124/72 mmHg (right arm), and 130/76 mmHg (left arm), symmetrical pulses in all four extremities, intact range of motion in shoulders and hips, Heberden’s and Bouchard’s nodes in both hands, and restricted range of motion of the cervical spine. There is a loud systolic and diastolic murmur, heard loudest at the aortic area, with no bruits over the carotid, subclavian, or iliofemoral vessels or the abdominal aorta. Laboratory studies reveal mild anemia (Hct 33 grams/dL /Hgb 11 percent), ESR 84 mm/hr, normal urinalysis, thyroid function studies, CK, LFTs and serum creatinine.
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Learning Objectives:
Upon successful completion of this educational activity, participants should be better able to assess and treat patients who present with musculoskeletal complaints.
Overview
Author(s)/Faculty: Gary S. Hoffman, MD, MS, MACR
Source: Healio Rheumatology Education Lab
Type: Monograph
Articles/Items: 4
Release Date: 2/15/2018
Expiration Date: 2/14/2019
Credit Type: CME/ABIM MOC
Number of Credits: 0.25
Cost: Free
Providers: Vindico Medical Education
CME Information
Provider Statement: This continuing medical education activity is provided by Vindico Medical Information.
Support Statement: There is no commercial support for this activity.
Target Audience: The intended audience for this activity is rheumatologists and other health care professionals involved in the treatment of rheumatoid arthritis.