A 29-year-old male with a known history of sickle cell disease and multiple blood transfusions was admitted through the ER with symptoms consistent with his prior sickle cell crises. He complained of pain in his knees, hips, and back that had been "off and on" for the last couple of months. It became markedly worse and began to involve his chest and his arms. He denies fevers, chills, rigors, or night sweats. Past medical history (PMH) Sickle cell disease, aseptic necrosis of bone (hips and back). Physical examination Stable vital signs (VSS).
Eyes: anicteric. ENT: Oropharynx clear, no plaques or exudates. Respiratory: clear to auscultation bilaterally, no respiratory distress, no rales, no rhonchi, no wheezing. Cardiovascular: no murmurs, no rubs, no gallops, regular rate and rhythm. Gastrointestinal: soft, nontender, nondistended. Genitourinary: no CVA tenderness Extremities: no…
