A Case of the Week
Case 208
A seventy two-year-old male suffered from neck pain, unable to rise his upper extremities, wrist pain and swollen dorsum of hands for a week. He had non-steroid anti-inflammatory drugs by himself but it did not abate him. Body temperature was 37.6°C. Medical findings figured out skin eruption on fore-arms and tenderness on cervical spinous process and para-vertebral muscles. Laboratory test revealed CRP 29.85 mg/dL, WBC 22960/mm3, platelet 482000/mm3, D-dimer 14.8μg, serum ferritin > 5000 ng/dL (20-280), AST 78 IU, ALT 91 IU, creatinine 1.11 mg/dL, interleukin 2R 2600 U/mL (157-474).
He agreed to take CT (Fig.1) and MRI (Figs 2-4).
What is your diagnosis ?
2020.10.14
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