ABSTRACT
A 70-year-old man was admitted to the emergency department following an episode of collapse while he was participating in an organised hill walk. He explained that his legs had become progressively weaker during the walk and eventually ‘gave way’. He felt that he had become generally weaker over recent weeks, and that, although he maintained an active lifestyle, he had noticed a decline in his exercise tolerance. His past medical history included alopecia areata and psoriasis. He used topical corticosteroid cream several times per week. He lived with his brother and was a retired piano tuner. He was an ex-smoker with a 40 pack year history.
