Introduction
Jenny is a 19 year old mathematics student at King’s College London. Over the last 6 weeks she has been feeling very tired, and struggling with joint pains in her hands and knees.
She has never had any serious medical problems before.
She books an appointment to see her general practitioner who takes a careful history about her presenting symptoms.
The initial pain in her joints started in her knuckles, before spreading to her wrists and in the last fortnight also her knees. She reports that the symptoms are worst in the mornings, and seem to improve as the day goes on.