Pain in the what?

I love rheumatology for all the bizarre and esoteric diseases, but let's be honest; I pretty much see the same three complaints over and over.

1) +ANA
2) hurts all over

We'll get to those some other day. Today's featured chief complaint is...
3) I don't know.

Me: So, in one sentence, tell me what brings you to a rheumatologist.
Patient: I got the appointment card in the mail.
Me: Sigh. OK. But why did you get the appointment?
Patient: Because my doctor made it for me.
Me: Bigger sigh. OK, but why did your doctor want you to see me?
Patient: I don't know.
Me: Biggest sigh ever. Any problems with your joints lately? Or rashes?
Patient: Nope.
[Insert an hour's worth of detailed medical questioning here.]
Me: Well, I've got great news. You don't have lupus.

Thank you for this interesting consultation. The patient has been seen and discussed with Dr. A, who agrees with the above assessment and plan.

Sincerely,
Beth Scholz, MD
Rheumatology fellow, PGY-4