Author: Katie Noble, Jennifer Cochrane / Editor: Nick Tilbury / Codes: DP1, DP2, IP1, MuP2, SLO1 / Published: 15/10/2020
A 33-year-old female presents to the Emergency Department with a three month history of worsening atraumatic left hip pain. Pain is exacerbated by weightbearing and movement, and current analgesia from her GP is no longer effective. She also reports increasing fatigue and generalised joint stiffness of several months duration – particularly in the mornings. Her past medical history includes thyroiditis and a DVT during pregnancy 2 years ago.
On examination, she has a tender left hip, the joint is not hot or erythematous and there is no obvious effusion compared to the right. She has a restricted range of movement in all directions and an antalgic gait.
Observations: RR 16, sats 100% on air, HR 92, BP 120/80, Temp 38.3

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Question 1 of 3
1. Question
An X-ray of her hip was performed.
What is the diagnosis?
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Question 2 of 3
2. Question
Her x-ray shows osteonecrosis of the femoral head.
Blood results show the following:
Hb 12.0, Plt 98, WCC 3.3
CRP 21
ESR 80
Creatinine 118You suspect she may have Systemic Lupus Erythematosus. What aspects of the history and investigation findings are supportive of this diagnosis?
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Question 3 of 3
3. Question
Which of the following mucocutaneous manifestations are associated with systemic lupus erythematosus?
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3 responses
Very interesting
BRILLIANT
Great case