FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 328:1621-1624 June 3, 1993 Number 22 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

A 71-year-old man consulted his doctor because he had had stiffness and swelling of his hands and feet, especially in the morning, for the previous six weeks.

Swelling of the hands and feet suggests arthritis or an edematous state, perhaps due to a low serum albumin level and a decrease in oncotic pressure. Swelling that is more pronounced in the morning is consistent with generalized edema, such as would occur with the nephrotic syndrome, cirrhosis, or constrictive pericarditis.

He had noticed an 8-lb (3.6 kg) weight gain and weakness of his legs, which he attributed to the swelling. He had . . . [Full Text of this Article]

Commentary

Source Information

From the Divisions of Clinical Decision Making and General Internal Medicine, New England Medical Center, Tufts University School of Medicine, Boston.

References

This article has been cited by other articles:

• Kassirer, J. P. (1995). Teaching Problem-Solving -- How Are We Doing?. NEJM 332: 1507-1509 [Full Text]  
• Pauker, S. G., Kopelman, R. I. (1994). Some Familiar Trade-offs. NEJM 331: 1511-1515 [Full Text]  
• Reich, J. S., Pauker, S. G., Thibault, G. E. (1993). Criticism of Clinical Problem-Solving. NEJM 329: 1743-1744 [Full Text]