title: Transient thyrotoxicosis as an initial presentation of rheumatoid arthritis: a case report.
abstract: BACKGROUND
  Few reports in the literature describe the association of rheumatoid arthritis and transient thyrotoxicosis. We report a case of rheumatoid arthritis and painless thyroiditis presenting simultaneously and acutely with a cluster of symptoms that initially made the diagnosis of rheumatoid arthritis very challenging.
  
  
  METHODS
  A 41-year-old Caucasian male presented with complaints of malaise and decreased range of motion in the left elbow. Physical examination and laboratory evaluation established the diagnosis of rheumatoid arthritis and painless thyroiditis.
  
  
  CONCLUSIONS
  When patients with rheumatoid arthritis present with numerous "extra articular" and constitutional symptoms, evaluation of thyroid disorder with thyroid function test should be considered to help establish the correct diagnosis.
authors.affiliation: Department of Medicine, University of Tennessee, College of Medicine 975 East Third Street, Suite 94, Chattanooga, TN 37403 USA. fmakdsi@hotmail.com
authors.forename: Fadi
authors.initials: F
authors.lastname: Makdsi
authors.forename: Michael
authors.initials: M
authors.lastname: Brit