BOF 55

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BOF: 55

A 67-year-old female presents with a swollen right leg. She gives a history of weight loss and also says she has had a rash over her buttocks.

On examination you note that her right calf is swollen, erythematous, warm, tense and tender. Over her buttocks you note an erythematous necrolytic rash.

Investigations

Hb 8.9 g/dL

WBC 11 x109 /L

Platelets 240

Glucose 14 mmol/L

In this patient which one of the following investigations is most likely to show the primary lesion?

a)      Gastroscopy and distal duodenal biopsy

b)      Colonoscopy and terminal ileal biopsy

c)      Endoscopic ultrasound

d)      Barium follow through

e)      White cell scan

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