05Sep

How a Clue From Her Medical History Helped Solve the Cause of a Patient’s Sore Elbow.

A 46-year-old female was seen in her primary care physician’s office for complaints of a sore elbow after returning from a three-week trail ride in rural Arizona. While the patient could not recall recent injuries to her arm or elbow, she did report treatment with azithromycin for a sinus infection two weeks before she left for the trail ride. However, at the time when she left for Arizona, she had completed the prescription and all her symptoms had resolved.

She reported that the elbow was not sore or swollen previously. When quizzed about her occupation, she reported that she was a successful horse trainer and an all-around champion of animals in general. She had a thriving dog rescue on her property, which was also home to several exotic birds, five tanks of tropical fish both freshwater and salt water, one iguana, and one pot belly pig.

In reviewing the clinical history, the physician noted that the patient had been a two-pack-a-day smoker for several years prior to this visit but had been successful in a smoking cessation program within the last year and now did not smoke at all. Over the previous winter, she had experienced some difficulty breathing, and a course of corticosteroids was prescribed by her pulmonologist. The breathing issues were resolved upon completion of the steroids.

The patient’s vital signs, including blood pressure and respiration, were all within normal adult range, and her temperature was 98.6°C. The physical exam was unremarkable except for a large swollen area just below the elbow on the right arm. The area on the arm was red, warm and very sore to the touch.

What was causing this patient’s swollen elbow? Find out how a medical mystery was resolved by obtaining a medical history and confirmed through laboratory testing. To learn about diagnosis and treatment, check out the August 2018 issue of the Journal of Continuing Education Topics & Issues.

AMT members and non-members can purchase access to this STEP article and other CE programs through the AMT online store. STEP articles appear in the AMT Journal of Continuing Education Topics & Issues. Each article includes a 10-question quiz which can be purchased and completed online. To receive CE for this article, “A Case of Opportunity: M. marinum,” purchase it here.

AMT members can apply CE from STEP articles to comply with the Certification Continuation Program (CCP).

 

Source:
Johnson, Deborah A.; Barham, Dr. Beverly J.; Webster, Kathryn E. (2018). A Case of Opportunity: M. Marinum. Journal of Continuing Education Topics & Issues Volume 20 Number 3, 72-77.

 

 

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