0
Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

A 44-Year-Old Woman With Polyarthritis, Fever, and Hilar Adenopathy*

Oscar Paniagua, MD; Kenneth M. Nugent, MD, FCCP
Author and Funding Information

*From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX.

Correspondence to: Kenneth Nugent, MD, FCCP, Department of Internal Medicine, Texas Tech University Health Sciences Center, 3601 Fourth St, STOP 9410, Lubbock TX 79430; e-mail: Kenneth.Nugent@ttuhsc.edu



Chest. 2006;129(3):816-821. doi:10.1378/chest.129.3.816
Text Size: A A A
Published online

Extract

A 44-year-old white woman presented with an 8-week history of increasing bilateral (right more than left) ankle pain with progressive periarticular edema and inflammation. The right wrist and both elbows were additively and mildly involved. She had intermittent fever with no clear pattern, malaise, mild thoracic spine pain, and intermittent limb muscle aches. Dry cough was present 4 days before hospital admission. The patient was treated with nonsteroidal antiinflammatory drugs and morphine at another hospital for 4 days before being transferred to our institution for management of asymmetric large-joint polyarthritis of unclear etiology. She denied sputum production, dyspnea, chest pain, syncope, headaches, visual disturbances, nausea, vomiting, abdominal pain, diarrhea, history of bleeding, dysuria, night sweats, weight loss, and skin rash. She was a resident of a small rural town, had a stable monogamous relationship with her husband, and had one healthy son. She worked for a local home health-care agency and denied tobacco, ethanol, drug abuse, recent exposure to animals, and recent travel. No drug allergies were noted. Home medications included glyburide/metformin (2.5/500 mg po bid), lisinopril (10 mg/d po), and ibuprofen as needed.

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

Suggested Readings

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543