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Dr. Mark
Dr. Mark, Neurologist (MD)
Category: Neurology
Satisfied Customers: 1985
Experience:  Neurosurgeon - Brain, spine, and peripheral nerve surgery
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I have a client who is 62 years old and is active in

Customer Question

I have a client who is 62 years old and is active in international affairs. He has significant developmental symptom-provoking instability of his ankles. Simply observing him walk, the instability is pronounced with a significant valgus enhancement in his ankle. Remarkably, no other health care practitioner has acknowledged the degree of severity. This will be appropriately managed with a rigid ankle-foot orthosis and orthopedic referral. He has generalized hypermobility syndrome, though particularly in distal extremities. He experienced diffuse stiffness in all major joints after lying down, sitting, etc. I am reluctant to simply ascribe the diffuse stiffness to hypermobility syndrome. A fascinating phenomenon is that when he exercises he very quickly bulks up notes that his shirts become tight, etc. He recently took on bicycling and is noting his arms bulking up, calves. He returns to baseline after discontinuing. He not present with any obvious gigantism. He gets two very comprehensive physicals a year as he was active in the after-effects of September 11, and also necessitated as he is a pilot. None of his medical providers have given any meaningful interpretation of the stiffness and bulking-up phenomenon. Today was his first visit and I mentioned that referral to an endocrinologist would be made. I am wondering if there is a correlation between his overall joint stiffness and the peculiar phenomenon of bulking up have any correlation? I would be most grateful for any advice you may provide.
Submitted: 1 year ago.
Category: Neurology
Customer: replied 1 year ago.
It appears that the answer has been default to neurology. I anticipate that neurology may have input on the phenomenon of being quite stiff with positional changes, going from lying to standing, walking, sit to stand, etc. However, I wonder if it is more appropriate to also ask an endocrinologist regarding the peculiar bulking-up phenomenon, and also if there could be any correlation with the stiff behavior? The latter, certainly an "outlier phenomenon" having never heard of such. I trust the patient's description as being genuine. Thank you.
Expert:  Dr. Phil, MD replied 1 year ago.

Any other medical issues?

Expert:  Dr. Phil, MD replied 1 year ago.

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