I thought she had been........ skiing!

'Have you been skiing?', I asked Amy, back in March. She looked like she had the facial tan of someone who had been wearing sunglasses on bright ski slopes. 'Nope', she replied, looking at me in a slightly surprised way.

Amy was about 35yrs old and had been getting back pain on and off over the years, sometimes quite severely. She sometimes found manipulative treatment painful, so would normally only come for one session, not returning for follow-ups until she had the next episode.

Her sacro-iliac joints tended to get a bit painful to touch, and there was quite a lot of tenderness in her Quadratus Lumborum muscles bilaterally. She was generally tender to touch. There had been times when urinalysis showed a trace of protein and blood in her urine, but nothing much. She was never a very cheery patient.

I suspected that she had lupus, and wrote to her GP suggesting blood tests, looking at her anti-nuclear antibodies. They were elevated. She probably had lupus, an auto-immune condition. She was getting back pain from her inflammed sacro-iliac joints as well as from her kidneys

Amy was prescribed hydroxychloroquine, which helped, but didn't cure her, of course. She would still come to see me for treatment, but I would try and treat her as gently as possible.

Questions:

Why did Amy look like she had been skiing?

Why did she find manipulative treatment painful?

Why was she never very cheery?

What is the demographic of lupus?

What are the downsides to her being on hydroxychloroquine?

Great summary of lupus in JAMA here

I am a chiropractor and sonographer. I also mentor colleagues to help them become the clinicians that they want to become. Find out more here.