Quiz Page December 2009: Polyuria, Proximal Muscle Weakness, Bone Pain, and Photophobia in an Adult
November 28, 2009 by admin
Quiz Page December 2009: Polyuria, Proximal Muscle Weakness, Bone Pain, and Photophobia in an Adult
A 33-year-old school teacher with no significant medical history or medication use presented with 3 months of lower back pain, proximal muscle weakness that limited his ability to stand, urinary frequency, and nocturia. Although denying dry mouth, dry eyes, or polydipsia, he describes frequent photophobia during this period. There was no blepharospasm, tearing, or decreased vision. On physical examination, blood pressure was 110/70 mm Hg and pulse rate was 72 beats/min. He had tenderness over his ribs bilaterally and painful restriction to flexion and extension of the ankle and knee joints. Proximal muscle strength in the upper and lower limbs was 4/5, deep tendon reflexes were present as a normal ankle jerk, superficial reflexes were normal, and there was no sensory deficit. Laboratory st…
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