Sunday, November 4, 2012

RS3PE

One day in EMG clinic, we had a patient with wrist pain and intermittent wrist swelling. His workup for rheumatological disease was negative and his EMG only showed mild carpal tunnel.

Attending: "So do you think he has RS3PE?"

Me: [thinking: "Am I supposed to know what that is??"] "Uhhh...."

Attending: "That's Remitting Seronegative Symmetrical Synovitis with Pitting Edema."

Me: "Um."

Attending: [points to bulletin board, where article is pinned up] "We saw a really interesting case of it last week. I'll bet that's what he has. Was his sed rate elevated?"

Me: "No."

Attending: "Maybe that's because he got prednisone."

Me: "It was normal before the prednisone."

Attending: "Well, it could still be RS3PE! We should put that diagnosis in our report!"

Me: [thinking] "Just because you have an article about something on the wall, that doesn't mean every patient has it."

I guess the diagnosis is possible. I love the fact that instead of calling it RSSSPE, they call it RS3PE.

5 comments:

  1. Reminds me of the quote, "when all you have is a hammer, everything looks like a nail."

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  2. I don't even go that far. I just write "Mild carpal tunnel syndrome. Clinical correlation is advised."

    Let the ordering physician deal with it.

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  3. Oh dear. Sounds like yet another scientific doctor. By virtue of walking in his exam room, you have one of the following 3 diseases.

    What? It doesn't quite fit? Well, it's certainly not RA. It doesn't seem to be explained by carpal tunnel. It must be {insert random obscure disease} via diagnosis by exclusion.

    Abigail

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  4. It could probably be turned into a song! :D

    R 3 S P E, C T
    Find out which one it could be...

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