BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b168 (Published 21 January 2009) Cite this as: BMJ 2009;338:b168
  1. Balaji Ramabhadran, specialist registrar in rheumatology,
  2. Peter Merry, consultant
  1. 1Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich NR4 7UY
  1. writetobala{at}hotmail.com

    A 40 year old man presented to the rheumatology clinic with polyarthralgia, chest pain, and malaise. He also noticed tenderness with elevation of “the tree trunk only” …

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