He has had pains in his elbows for approximately four months. It is relatively constant, no extreme. It does tend to hurt when he supinates his forearm fully. He has also had some mild pain in the back. He has no other significant history.
Tympanic membranes are clear bilaterally.
Nose and throat are clear. Neck is supple without lymphadenopathy or bruits. Soft, flat, nontender, and nondistended. Bowel sound are active. He has some minimal tenderness in the right lower quadrant.