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Previous Volume 329:1716-1719 December 2, 1993 Number 23 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.

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A 25-year-old, previously healthy white man consulted his physician because of a two-month history of progressive diffuse joint pain. Initially, the patient noticed pain in his left elbow on awakening. The pain soon involved both knees and ankles and persisted for longer periods during the day; it then became constant and was accompanied by fatigue. One month after the onset of joint pain, low back stiffness developed, which was worse on awakening, improved with activity, and increased again at the end of the day. The physical examination was unremarkable. The erythrocyte sedimentation rate was 20 mm per hour, the white-cell . . . [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.

Address reprint requests to Dr. Pauker at New England Medical Center, Mailstop 35K9, Box 302, 750 Washington St., Boston, MA 02111.

References

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• Kassirer, J. P. (1995). Teaching Problem-Solving -- How Are We Doing?. NEJM 332: 1507-1509 [Full Text]  
• Schiff, G. D. (1994). Commentary: Diagnosis Tracking and Health Reform. American Journal of Medical Quality 9: 149-152 [Abstract]