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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 347:272-278 July 25, 2002 Number 4
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Case 23-2002 — A 73-Year-Old Man with Leg Pains, Occipital Headaches, and Night Sweats
William P. Docken, and Eugene J. Mark

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Presentation of Case

A 73-year-old man was admitted to the hospital because of leg pains, occipital headaches, and night sweats.

He had been in good health until two months earlier, when he began to experience episodes that began with a sensation of "cold feet," followed by a right-sided occipital headache and then by bilateral knee, calf, and ankle pain with "throbbing" in the affected bones. The headache was dull and was relieved by acetaminophen (650 mg) after 15 minutes. At that point, he would fall asleep, only to awaken 45 minutes later with sweating that was profuse on most nights, accompanied by a . . . [Full Text of this Article]

Differential Diagnosis

Epidemiology

History

            Fever

            Headache

            Constitutional Symptoms

Physical Examination

Laboratory Data

            Erythrocyte Sedimentation Rate

            Serum Ferritin Level

            Liver-Function Tests

Absent Clinical Features

Temporal-Artery Biopsy

Clinical Diagnosis

Dr. William P. Docken's Diagnosis

Pathological Discussion

Anatomical Diagnosis




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