Subacute polyarticular arthralgia.
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travel to the Dominican Republic x?
A 78-year-old woman with a history of anxiety and hypertension presented to our family
medicine residency practice in Massachusetts with subacute polyarticular arthralgias that
had been present for 2 months. She complained of pain and swelling of both ankles and the
right knee. She noted that her symptoms had started on a recent trip to the Dominican
Republic, where she developed generalized joint pain and a fever that lasted 1 to 2 weeks
and subsequently resolved with the lingering polyarthralgia. She denied any rash,
constitutional symptoms, photosensitivity, headaches, photophobia, or history of tick bite.
Physical examination revealed normal vital signs, notable warmth and swelling of the
bilateral ankles that was worse on the right side, and swelling of the right knee with
effusionµt no tenderness/ palpation.
Possible Diagnosis with rationale explanation.
At least 3 differentials must be mentioned with rationales explanation.
Use at least 3 Citations or References with no more than 7 years old.
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