50 yr old female presented with complaint of ghabrahat and palpitations she had history of deformity on both hands with history of rheumatoid arthritis from last 20 yrs . She was on treatment on and off from various institutions. Now from last 2 years she is not consulting any physician and not having recent reports. Kindly shre the next step with proper investigation and management 🙏

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RA with Swan neck/ Boutonnaire deformity... Complete workup including ESR/CRP , HRCT to look for ILD, Echo & other baseline investigations req

Proper investigation is the first step as the patient's current condition is unknown Also for P/H/O bilateral deformity with RA kindly refer the patient to an Orthopaedic Surgeon and Physio specialized in Ortho .

TFT Sugar Arthritis profile

Rt little finger contracture For repair Opinion of orthopedic Rheumatologist Known case of ra Methotrexate 20 mg once a week Steriod in tapper doses Folinic acid Remission is known Disease modifying drug

? ARTHROPATHY WITH .. ANXIETY NEUROSIS .. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. HEMOGRAM.. RA FACTOR.. CRP .. ELECTROLYTES.. CARDIAC PROFILE.. CXR STUDY..

Tnx Dr Priyanka pawar
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Start Base line as Dr musaib bin said, and if possible then advise Eco also.

Typical Swan neck deformities of RA Start from CBC ESR Rh factor Cardiac profile S Electrolytes Thyroid function tests

∆sistic test :- ECG CBC CXR ESR RF for rheumatoid arthritis conditions RTPCR

Dd anxiety? Lvh?svt? thyrotoxicosis?a fib?severe anemia?bp?diabetes? Adv serum t3,t4,tsh,ecg,cxr,echo.

Typical swanneck and bouteinaire deformities Start from all baseline investigations ECG is a must to rule out arrythmaias R/o anemia of chronic disease Cxr Electrolytes Esr crp, rheuamatic factor and anti ccp to be repeated after baseline is done with

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