My Leg Hurts
Patient presents with: Severe heal pain with the first couple of steps in the morning, pain with each step, point tenderness on the bottom of the foot with dorsiflexion
Plantar fasciitis
athletic middle aged male presents with: lateral elbow pain, worse with gripping and throwing, pinpoint pain on lateral epicondyle
tennis elbow
patient greater than 50 years old presents with weight loss, fever, chronic bilateral pain in back, shoulders, hips, normocytic anemia, ESR 80, normal CPK
PMR
24 year old male with no PMH presents with new onset hypertension, fever, malaise, vague abdominal pain, testicular pain, leukocytosis, normocytic anemia, + HBsAg
PAN
p-ANCA
microscopic polyangiitis, vasculitis
Patient with known OA of the knee presents with: worsened knee pain that wakes patient up from sleep, point tenderness on the inferomedial aspect of the knee (4-6 cm below patella)
pes anserine bursitis
Patient with RA presents with : swollen tender elbow, erythema and heat over the posterior portion of elbow, normal extension and flexion
olecranon bursitis
Patient with HCV presents with: malaise arthralgias, pins and needles sensation in both feet, scattered lymphadenopathy, decreased complement,
cryoglobulinemic vasculitis
Patient with known RA presents with:
Occipital headache
Mild loss of sensation to touch in both hands
Bilateral decreased grip strength
C1-C2 subluxation
antitopoisomerase -1
Systemic sclerosis
Patients who lays carpet for a living presents with: painful swollen knee, erythema and localized tenderness over the patella, normal ROM
pre patellar bursitis
Diabetic 50 year old patient presents with: chronic shoulder pain that limits overhead reach, gradual shoulder stiffness and decreased ROM, normal x-ray
adhesive capsulitis
female patient with : fatigue, myalgias, mental fogginess, interrupted sleep, normal labs
fibromyalgia
Recurrent swollen and painful wrist without trauma
Mildly increased ALT/AST
Radiographic evidence of chondrocalcinosis and hooked osteophytes at MCP 2,3
Hemochromatosis
anti scl 70
systemic sclerosis
patient with known RA and a chronic knee effusion presents with: acute pain and swelling behind the knee, soft swollen area in the popliteal fossa
Bakers cyst
Lateral shoulder pain that disrupts sleep and inhibits ROM, most intense 4 inches down outer arm, reduced active but normal passive shoulder ROM
sub acromial bursitis
69 year old male patient presents with years of: progressive weakness of the hands: proximal muscles, reduced DTRs, mildly elevated AST,ALT,LDH, negative ANA, normal ESR. Muscle biopsy shows rimmed vacuoles and ragged red fibers
inclusion body myositis
Obese patient presents with:
Pain and stiffness in unilateral groin area, worse with weight bearing and better with rest
Lack of inflammation, no effusion, crepitus or bony swelling
Standing radiographs of the hip show joint space narrowing and osteophytes without erosions
Hip osteoarthritis
antihistone
drug induced lupus
Patients presents with: hip pain on the outer thigh, especially when lying flat, point tenderness over the lateral hip, normal gait, normal ROM, normal x rays
trochanteric bursitis
nocturnal paresthesia and pain of the first three fingers in someone with hypothyroidism
CTS
Patient with DM2, HL, HTN on DDP4 on Januvia,lipitor,cozaar, develops diffuse muscle pain and weakness, increased AST,ALT, LDH, and CPK
statin induced myopathy
35 year old presents with:
Fatigue, intermittent fever and weight loss
Arthralgias and stiffness in hands and knees > 1 hour every morning
Bilateral wrist and MCP synovitis with decreased ROM in wrists and fingers
Hand radiographs: Erosions and joint space narrowing
Decreased H/H with normal MCV and MCHC
Increased ESR and + anti CCP
Seropositive RA
mixed connective tissue disorder
U1RNP