A 50 years male patient came with symptoms of pain around knee joint.pain increased in activity.patient has vitD3 deficiency.patient is hypertensive and diabetic.please diagnose and suggest treatment...

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Physiotherapists should work with in their limits, it is better to refer the Patient to near by qualified Orthopaedic surgeon. Maintain the PATIENTS file , followup the case look for expected as well as unexpected results/ outcome. We see lot many buggered up cases handled / mismanaged by all sorts of self DECLARED super consultans , with funny degrees/ titles on their letterheads/ Display boards. Look at The images if one hit the diagnosis , then there is nothing like CLINICAL ACUMEN. You / one cannot treat patients in fraction / pices. Giving opinion like VIT D , Anal gesic gel is WORST way TREATMENT even with out seeing the PATIENTS.
More than 80% population have low 25 hydroxy vitamin d level, more than 3o% have diabetes. More useful history may be obesity if it has pain on downhill walking (pf arthritis), if yes then weight reduction is first priority. Investigations like uric acid , history of hyperuricemia/trauma in past. Specially in younger patients- posteroanterior x-ray of knee in 45 degree of flexion For tunnel view to rule out osteochondrititis dessicans(unlikely here as no theatre sign), osteonecrosis. First d/d here is osteoarthritic as PT age- more than 40. For Younger pt if pain increses on activity d/d also includes bursitis, tendinitis.
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OA knee and according to this go for basic physiotherapy management nothing else focus on quads & hams strengthening exercises.
Grade 2 arthritis knee, Give OA reaction brace donjoy Quadriceps exercises Analgesic gel Vit d and calcium
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OA of knee w reducing joint space in medial compartment; Adv for PFO
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osteoarthritis of knee
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OA knee,, Manual therapy, ITb release (manually at its isertion or dry needling), theraband loop exercises for knee; mosterwalk for proximal stability,, wil improve functions drastically in a wk.
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Osteoarthritis most likely. Since pt is also HTN +DM -prescribe Teamadol, calcium supplement, knee traction .Do blood sugar monitoring. For HTN losartan is best option.
Well she has osteoarthritis. If there sis clear signs for meniscal injury get an mri done or else muscle strengthening exercises and VIT D supplements should be fine
OA knee with medial side jt space reduced .adv physiotherapy knee jt. Investigate properly.needs PFO.
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