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Teachable Moment
Less Is More
December 2015

The Value of the History and Physical Examination—Sailing Through Medicine With Modern ToolsA Teachable Moment

Author Affiliations
  • 1Yale Waterbury Internal Medicine Residency Program, Yale University School of Medicine, New Haven, Connecticut
  • 2Yale Cardiovascular Research Center, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
  • 3Department of Medicine, Waterbury Hospital, Waterbury, Connecticut
  • 4Department of Rheumatology, Yale University School of Medicine, New Haven, Connecticut
JAMA Intern Med. 2015;175(12):1901-1902. doi:10.1001/jamainternmed.2015.5768

A middle-aged woman presented to the emergency department with severe ankle pain, generalized body aches, malaise, and petechial rash over her extremities. The symptoms had been present for about a year, but on the night of presentation her husband, concerned over the worsening rash and crippling ankle pain, carried her to the emergency department. Her medical records revealed prior outpatient evaluation with laboratory tests, whole-body computed tomography with intravenous contrast, and whole-body scintigraphy. All test results were normal. She had been prescribed pain medications to treat her body aches and antidepressants for malaise.

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