Case 9-2007 A 27-Year-Old Woman with Pain and Swelling of the Legs

• Published in: The New England journal of medicine Vol. 356; no. 12; pp. 1252 - 1259
• Main Authors: Vallat, Jean-Michel, Cros, Didier P, Hedley-Whyte, E. Tessa
• Format: Journal Article
• Language: English
• Published: Boston Massachusetts Medical Society 22-03-2007
• Subjects: Hypothyroidism; Neurology; Thyroid gland
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMcpc079003

A 27-year-old woman had the sudden onset of pain in the feet, more in the left foot than in the right, associated with edema of the lower legs and a rash over the feet and toes. Pain and paresthesia persisted and worsened; a neurologic examination revealed normal motor strength and reflexes but decreased sensation to pinprick in the toes. A diagnostic procedure was performed.
Presentation of Case
A 27-year-old woman was seen in the neurology clinic because of pain and swelling in her feet. She had been well until approximately 5 months earlier, when swelling of her ankles and lower legs developed that was worse on the left side, varied in severity from day to day, and was not affected by position. Approximately 6 weeks later, she was awakened from sleep by burning and stinging pain on the dorsal aspect of her left foot, which was aggravated by pressure and lasted for 3 to 4 hours. The next day, she noted tingling in the . . .