20th February 2025

He reports no past medical conditions and apart from the occasional ibuprofen for headaches, he is not on any regular medications.

He reports no past medical conditions and apart from the occasional ibuprofen for headaches, he is not on any regular medications. He works as an estate agent. He does not smoke and drinks 10 units of alcohol a week. 

On examination, the chest is clear and heart sounds are normal. There is no joint deformity but he is tender over his ankles. You also note a tender rash over his shins.

Blood tests show a mildly elevated CRP but are otherwise unremarkable. CXR is reported as bilateral lymphadenopathy.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.