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Seen in the ED Quiz: Severe Wrist and Knee Pain in an Older Man
The man in his early 70s complains of leg pain lasting a month and of arm pain that came on about 1 week ago. Does the x-ray offer a clue to a diagnosis?
History of present illness. A man in his early seventies presents to the hospital with 1 month of left leg pain and 1 week of left arm pain. He has a history of high cholesterol, hypertension, and diabetes. He states that the arm hurts from his shoulder all the way down to his hand and the entire left leg hurts as well, but not as bad as the arm. If he had to say which areas hurt the most it would be his left wrist followed by his left knee. He is unsure if there is weakness because the pain is so severe, but he denies any numbness, injury, fever, chest pain, shortness of breath, or other complaints.
Vital signs & physical examination. Vital signs are normal. The physical exam is otherwise normal except for swelling and redness to the left wrist and a possible small effusion of the left knee without any erythema. No induration is noted at either site.
Initial diagnostic testing
CBC: normal
Chem-7: normal
Imaging: X-ray, below
What is the most likely diagnosis?
Primary Viewpoints Episode 7: Antidepressants for Back Pain, Osteoarthritis Pain
February 25th 2021Listen to our newest podcast episode where the lead author of a recent meta-analysis shares his findings on the safety and efficacy of antidepressant medications to treat back and osteoarthritis pain.
Podcast: Arthritis, Anxiety, and Depression: Managing a Common Comorbidity
May 14th 2012Anxiety is even more common than depression among people who have arthritis, a new study has shown. Here to discuss the implications for diagnosis and treatment is Eilzabeth Lin MD, a family medicine physician who is a longstanding researcher in the field of depression and pain.
