A vegetarian complains of polyarthralgia and tiredness
Should he exercise more and change his diet?
Tom, a 43-year-old architect of Caucasian descent, presents with a six-month history of polyarthralgia and tiredness, which is impacting his ability to run his company.
Recently, Tom has experienced dull aches in his joints, especially in his right hand, wrist and elbow, with associated stiffness in the morning, which gets better during the day after some movement.
At first, he thought this was ‘tennis elbow’ associated with overexercise weeks ago. However, the discomfort has continued, leading him to seek