“When can I go home?”

It was a routine referral to the rheumatology clinic: a general practitioner had requested advice about the management of arthritic pain in a 78 year old woman. We met her at the Friday afternoon clinic, when she came with her daughter in law. Her joint pain had improved since she had seen her general practitioner. She had osteoarthritic changes in her hands and knees, as expected, but no features of inflammatory arthritis. She was remarkably thin and had recently lost a lot of weight. I wondered whether she had an underlying malignancy. She agreed …