ABSTRACT
A 36-year-old woman was reviewed in the rheumatology clinic after developing a flare of her rheumatoid arthritis. She had experienced widespread joint swelling. She also complained of extreme fatigue and a feeling of general malaise. She had no other past medical history and usually managed her rheumatoid arthritis pain with naproxen tablets. She worked as a swimming instructor, did not drink alcohol and had never smoked.
