JAMA Clinical Challenge
March 15, 2016

Neck Pain, Stiffness, and Periorbital Edema in a Man With Diabetes

Author Affiliations
  • 1Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2016;315(11):1159-1160. doi:10.1001/jama.2016.1770

A 61-year-old man with history of hypertension, type 2 diabetes, and hypothyroidism presented for evaluation of neck pain, stiffness, and occipital headaches lasting 4 years. Acetaminophen and meloxicam provided only partial relief. He also noted progressive thickening of skin in the nape of his neck. He denied any prior history of Raynaud phenomenon; heart, kidney, or liver disease; diabetic retinopathy; nephropathy; or neuropathy. He had quit smoking 24 years ago and reported currently drinking 3 glasses of wine per week. His medications included rosiglitazone, glimepiride, and levothyroxine.

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