Further History
Jenny Rigg
19, Female
The GP enquires about recent infections of the gut or urinary tract – and there are none. There is no history of contact with young children.
In addition to the joint pains and tiredness, the GP also identifies that she has suffered with poor circulation in her hands for around 3 months. She describes episodes where several of fingers going white. This is triggered when she touches something cold (like taking things out of the fridge). After a few minutes the fingers gradually go blue, before suddenly warming up again and going red 4 or 5 minutes later. The red stage is burning and painful.
Another symptom the GP picks up on is that she is getting frequent mouth ulcers, and is concerned that her hair is falling out.
Images 1 and 2 should be reviewed to see the colour changes in the hands and also the mouth ulcers.
