New patient, 33 Y/O male in very good health referred by Primary Care after unsuccessful arthritic work-up.
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One month ago, for no apparent reason, this patient had swelling in both ankles and his left knee. No redness; but pain, not severe but painful on motion. No history of previous flare ups or any arthritic history. No apparent or obvious initiating factors. He was checked for Lymes and RA screening. CBC and ESR normal.
Undr examination he is WD/WN with no obvious clinical pathology. His ankles and knee appear normal. His x-rays were normal except early DJD left ankle which he attributed to an old severe ankle sprain.
OK ====== this is the kicker. Two weeks prior to his flare up his wife had a similar attack to both hands and one elbow!
They are both healthy, no recent trips out of the country, lived in the same home for past two years. No children. 2 Cats, healthy. Have not been in or visited the hospital or anyone sick. No histroy of recent flu or cold symptoms, no bites. No change in diet.
Any ideas?
Thanks
Steve
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