On rectal examination there were no anal fissures. The small amount of stool in the rectum was soft and mildly hemeoccult positive. While he complained of severe knee and ankle pain, the joints were not warm or erythematous, but there was some periarticular edema. Past medical history is unremarkable. There is no history of serious illnesses, hospitalizations, or surgical procedures.
Family history is benign.
White blood cell count is 12,500 with a normal differential count. Platelet count is 220,000. Liver function studies, electrolytes, serum amylase and lipase are all normal as is his urinalysis.