A 31-year-old female presented to the emergency department with chest and facial pain. History of rhinitis and cough 6 weeks prior to her current presentation. She was treated with antibiotics however, there was no relief. She then developed pain and swelling on the bridge of her nose, bilateral cheeks, and bilateral eyelids. She was treated with a brief course of corticosteroids with mild relief in symptoms. Present symptoms along with the facial pain include migratory pleuritic chest pain associated with tenderness to palpation over the areas of pain since 4 weeks.
Physical Examination Pain +++ to palpation over the costal cartilage (right 4-5th ribs). Saddle nose deformity with edematous nasal mucosa. Negative for nasal crusting or epistaxis. No auricular inflammation, tracheal tenderness, or synovitis. No diminished hearing or vision or sensory loss. Laboratory Findings ESR- 46…
