The patient has noted the pain for approximately 6 months, each time she carries laundry up to the second floor from the basement. She has not noted the pain at other times and the pain has never awakened her from sleep. She takes HCTZ 25 mg daily, for her hypertension. She underwent an abdominal hysterectomy at age 39 for chronic dysfunctional uterine bleeding. She previously smoked 1 pack of cigarettes per day for 25 years, quitting approximately 12 years ago.
Skin is warm and dry without xanthelasmas or jaundice.
Neck is supple without jugular venous distention or carotid bruits. Lungs are clear to auscultation bilaterally. No S3 murmur or rub. Abdomen is soft, round, nontender without masses, organomegaly, or bruits. No edema, ulcers, stasis changes or clubbing is noted.