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Case 36 

Case 36
Chapter:
Case 36
Author(s):

Joel David

, Anne Miller

, Anushka Soni

, and Lyn Williamson

DOI:
10.1093/med/9780199587506.003.0036
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date: 18 August 2019

A 71-year-old woman presented to the rheumatology clinic with a painful ulcer of the right lower leg. She reported worsening fatigue over the previous 6 months and had lost about half a stone in weight over this time. She was known to have RF-positive rheumatoid arthritis, diagnosed 40 years previously. Her disease had been difficult to control and she had undergone multiple joint replacements and spinal stabilization. She had had leg ulcers in the past but was concerned that this ulcer was not healing, was intensely painful, and often bled.

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