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Case 35 

Case 35
Chapter:
Case 35
Author(s):

Joel David

, Anne Miller

, Anushka Soni

, and Lyn Williamson

DOI:
10.1093/med/9780199587506.003.0035
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date: 23 August 2019

A 29-year-old man was referred to the rheumatology outpatient department with a 2-month history of cramps and muscular aching in his arms and thighs. He was normally healthy, apart from hay fever in the summer. He worked as a forklift-truck driver in a warehouse. He had no significant family history, apart from non-insulin-dependent diabetes in his father, and his only travel in the preceding 5 years had been to Europe. He exercised regularly and had run a marathon 3 months previously. Following the marathon, he recalled having an upper respiratory infection and cough which had settled completely with a 7-day course of amoxicillin. On direct questioning, he denied rash or Raynaud’s phenomenon.

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