In this case report, a patient with voriconazole-induced periostitis exhibits classic symptoms & elevated ALP levels, which quickly resolve following the discontinuation of voriconazole.
Search results for: palpation
Case Report: Complicated Presentation Eventually Explained by Rare Syndrome
Pachydermoperiostosis (PDP), also known as Touraine-Solente-Golé syndrome or primary hypertrophic osteoarthropathy, is a rare syndrome that can be inherited as autosomal dominant, autosomal recessive, or sporadically. This progressive disease primarily affects males, who tend to have more severe features than females. PDP usually occurs during adolescence, often starting around puberty.1 The main clinical features are…
Case Report: Sweet Syndrome as an Initial Presentation of Crohn’s Disease
Acute febrile neutrophilic dermatosis, or Sweet syndrome, is an inflammatory disease that classically presents with fever, leukocytosis and tender, erythematous plaques characterized by neutrophilic infiltrates on biopsy. Sweet syndrome has been reported in association with several autoimmune diseases, including inflammatory bowel disease, systemic lupus erythematous, rheumatoid arthritis and sarcoidosis.1 Here, we discuss a case of…
How to Avoid Cognitive Errors in Rheumatology
The 1999 Institute of Medicine report To Err Is Human gave a sobering depiction of the magnitude and consequences of medical error.1 The report concluded that approximately 98,000 people die in hospitals annually due to preventable medical errors. Of all the errors detailed in this report, diagnostic errors have since been determined to be the…
Case Report: A Rare Mimic of Giant Cell Arteritis
Syphilis is a chronic sexually transmitted disease (STD) caused by the spirochete Treponema pallidum. The clinical manifestations of syphilis are divided into four stages: 1) the primary stage, characterized by painless mucosal or cutaneous chancre at the site of infection that resolves spontaneously; 2) the secondary stage in which a generalized maculopapular rash and condyloma…
Case Report: Does a Young Woman with Gitelman Syndrome Have Gout?
Gout is the most common type of inflammatory arthritis in adults, and it typically occurs in men over the age of 50. When gout presents in younger patients or in women, this should warrant consideration of secondary causes. We describe an unusual genetic cause of tophaceous gout in a young, premenopausal woman. Case Report In…
Case Report: A Rare But Severe Complication of Dermatomyositis
Dermatomyositis is an uncommon autoimmune condition involving skeletal muscle characterized by subacute onset of progressive weakness, intramuscular inflammatory infiltrates and the presence of myositis-specific autoantibodies.1 Immune-mediated myopathies may exert some pathogenic effects on the muscle tissue by targeting the microvasculature.1 Capillary inflammation, fragility and loss may contribute to heightened bleeding events in these patients. Here,…
Case Report: Does She Have a Fungal Infection or Autoimmune Disease?
A 61-year-old Caucasian woman with a history of seropositive rheumatoid arthritis (RA) was hospitalized for a several-month history of progressively worsening left ankle pain and swelling. She had been unable to bear weight on her left leg for several days and did not notice improvement in symptoms with 20 mg of prednisone daily, which she…
Ultrasound in Rheumatology—Past, Present & Future
For most rheumatologists, the key elements of the physical exam—inspection, palpation, percussion and auscultation—have long been second nature, but a fifth modality has grown in importance with respect to making the correct diagnosis: ultrasound. From evaluating for Doppler signal and additional findings indicative of synovitis to identifying bony erosions, chondrocalcinosis, tophi and other articular and…
Case Report: A Patient’s Clubbing & Arthralgias Resist Diagnosis
A 59-year-old woman presented to our rheumatology clinic with a six-month history of a symmetric polyarthritis. She initially experienced pain in both knees. As time progressed, she began to notice pain in her ankles, hips, shoulders, hands and feet. She experienced joint stiffness lasting for more than 30 minutes every morning. She also described worsening…
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