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Back pain and fever
Karim Raza, Paru King, Simon P Allison
Department of
Endocrinology, Queen's Medical Centre, Nottingham NG7 2UH, UK
Correspondence to: Karim Raza, Specialist Registrar, Department of Rheumatology, The Guest Hospital, Dudley DY1 4SE, UK
Accepted 22 June
1998
| The first 150 words of the full text of this article appear below. |
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Introduction |
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A 39-year-old man was woken by mid-thoracic back pain
and sweating. The back pain resolved spontaneously over an hour, and he
was left with epigastric discomfort. There were no other symptoms, no
history of trauma, no past medical or family history of note, and he
had not been abroad. He was a smoker and took no medications. On
examination, he was of normal appearance, apyrexial and comfortable. Pulse was 90 beats/min, blood pressure 135/80 mmHg, and all pulses symmetrical. Heart sounds were normal with no added sounds, and respiratory examination was unremarkable. There was epigastric tenderness but no peritonism. The spine was not tender and had a full
range of movement. Investigations showed a raised white cell count (14 × 109/l), and neutrophil count (12 × 109/l), but haemoglobin, platelet count, electrolytes,
creatine kinase, amylase, electrocardiogram, chest and thoracic spine
radiographs, abdominal ultrasound and upper gastrointestinal endoscopy
were all normal. Over the next
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