What's causing these green and gold nails?

A patient with a number of chronic conditions presents on this occasion with oddly coloured nails

Earl is 78; he retired from the public service more than 20 years ago because of his rheumatoid arthritis.

He received what was conventional treatment at the time but unfortunately the disease progressed.

Now he is very disabled in spite of bilateral knee joint replacements.

He was a heavy cigarette smoker until his mid-50s and has had symptoms of COPD for some time.

Today he is brought into the surgery in a wheelchair, his joints are painful and he is dyspnoeic on modest exertion.


 Have an interesting case report? Click here to email the editor. We pay $400 for each case.


Examination

Your examination shows many painful, swollen joints, including the thumbs, wrists, shoulders, knees and ankles.

There is brawny non-pitting oedema of

Latest

Trending