Clinical Challenge 1 – The ill-defined inflammation
🟢 Stage 1 – Initial Assessment
Presentation
A fit & well gentleman in his 50s presented to SDEC with a 1/52 history of fatigue, fever, myalgia and joint pains with stiffness. His symptoms began shortly after a viral illness including a sore throat.
He denied any recent travel, alcohol or recreational drug use and took no regular medications. His only PMH was transient juvenile arthropathy during childhood.
Assessment
Observations
- Temperature 38.5°C
- Heart rate 105 bpm
- Blood pressure stable
- Oxygen saturations normal
He appeared sweaty but comfortable. He was alert & orientated with no focal neurology. He described widespread joint pain, although this was marked in the right shoulder, resulting in mildly reduced range of movement despite no preceding trauma.
There was:
- no rash
- no joint swelling
- no peripheral oedema
- no clinical evidence of DVT
Cardio-respiratory and abdominal exam were otherwise unremarkable.
Initial Investigations
| Investigation | Result |
| CRP | 450 |
| WCC | 25 |
| Neutrophils | 20 |
| ALP | 200 |
| Bilirubin | 25 |
| INR | 1.6 |
| Albumin | 20 |
| Glucose | 20 |
Renal function, electrolytes and the remainder of the FBC were unremarkable.
VBG, ECG & CXR showed nil acute.
🧠 Your Challenge
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🟢 Stage 2 – Patient Progress (Coming Soon)
🟢 Stage 3 – Diagnosis & Discussion (Coming Soon)
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