Clinical Case Database / Category: Clinical Care


Publication details

Dr. Arun Khanna MBBS MRCP, Dr Madhavi Chawla MBBS, Mr Anil Khanna, Nicola Maffulli MD, MS, PhD, FRCS(Orth)
Foundation Years Journal, volume 3, issue 8, p.52 (123Doc Education, London, October 2010)


A 42-year-old woman was admitted to the Medical Admissions Unit with dysphagia that had worsened over the last few months. Ingesting liquids was particularly problematic. She lost a stone in weight over several months. She denied any other gastrointestinal symptoms. She lives with her husband and recently started to be out of breath while doing household chores. When questioned, she reports that her fingers turned pale on exposure to the cold and that her skin had become thickened over the last few months. Various soothing creams and lotions did not help. She started to experience difficulty opening her mouth lately. On examination, there was sclerodactyly, telengiestasia, calcinosis cutis, microstomia and scleroderma limited to face and hands. A case of Limited Cutaneous Systemic Sclerosis is suspected as the likely diagnosis.

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Dr. Arun Khanna MBBS MRCP

Speciality registrar year 2 (Medicine)
Musgrove Park Hospital

Dr Madhavi Chawla MBBS

Musgrove Park Hospital

Mr Anil Khanna

Registrar in Orthopaedics
University Hospital North Staffordshire

Nicola Maffulli MD, MS, PhD, FRCS(Orth)

Centre Lead and Professor of Sports and Exercise Medicine
Consultant Trauma and Orthopaedic Surgeon
Centre for Sports and Exercise Medicine
Barts and The London School of Medicine and Dentistry
Mile End Hospital
275 Bancroft Road
London E1 4DG


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.