RT Book, Section
A1 Murtagh AO, John
A1 Bird, Sara
SR Print(0)
ID 1163949662
T1 Musculoskeletal twists and turns
T2 Murtagh's Cautionary Tales, 3rd Edition
YR 2019
FD 2019
PB McGraw-Hill Education (Australia) Pty Ltd
PP Sydney, Australia
SN 9781743767443
LK murtagh.mhmedical.com/content.aspx?aid=1163949662
RD 2024/04/25
AB Susan,  a  39-year-old  fashion  designer,  presented  because  of  very  severe  pain  in  her  lower  back  and  legs.  The  problem  followed  a  febrile  illness  of  sudden  onset  following  a  recent  business  trip  to  Singapore  and  Thailand.  She  had  attributed  the  pain  to  a  recurrence  of  an  old  problem  of  sciatica  and  was  concerned  that  she  may  have  been  infected  with  swine  flu.  Two  days  before  our  appointment,  she  had  visited  an  emergency  department  for  pain  relief  and  was  prescribed  oxycodone  because  Panadeine  Forte  was  ineffective.  She  said  that  now  the  pains  in  her  legs  were  unbearable  and  not  responding  well  to  opioids.  Further  detailed  history  revealed  that  she  had  associated  fever,  malaise,  nausea,  headache  and  generalised  muscular  aching.  She  also  admitted  to  feeling  very  depressed—even  suicidal.  On  physical  examination  there  were  no  specific  musculoskeletal  or  neurological  signs  (despite  the  severe  pain),  just  a  temperature  of  38.2  °C.