In this new occasional feature, Jacksonville University School of Nursing faculty discuss symptoms, diagnoses and treatments based on composites of patient cases handled by instructors, students and alumni of JUs local training programs. Todays article is the first in the series.

Stiff muscles, joint pain, even discolored urine. A potpourri of symptoms, but how do you know whats causing it? Sometimes, having the right combination of several symptoms can lead to the right diagnosis.

This happened in two cases handled by Michelle Edmonds, family nurse practitioner and full-time associate professor of nursing at Jacksonville University. In both cases, the patients were found to have the same condition, one that is more common than people realize but if unchecked can lead to serious kidney issues.

People often disregard these symptoms due to their busy lives or think they are related to something else, Edmonds said. The signs and symptoms of this condition often have a slow onset and vague presentation so that it may go several days without intervention.

Lets take a look at what happened in these two cases.

SARAH

Sarah, a healthy 20-year-old, had experienced vague hip and upper leg pain for four weeks. She was usually very active, but was in so much pain she could hardly fall asleep at night. She had not had any recent injuries and hadnt even been running like she used to.

The only thing different was that she had taken a common prescription oral acne medication the month prior to the hip and leg pain. She did fine for the first four weeks on this medication, but during the fifth and final week, the pain started.

Sarah followed the directions of the specialist: Avoid strenuous activity because of possible muscle damage while taking the medication. But she received no relief from any over-the-counter pain medications she tried.

Edmonds ordered some laboratory tests and an X-ray of the hips. One test showed that her level of creatine kinase (CK), an enzyme found in skeletal muscle, was almost five times higher than normal.

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New T-U feature will provide insights from JU's School of Nursing