Concluded Case

rheumatoid arthritis

65y/f came with complaint of stiffness in left hand/wrist joint with restricted movement of left shoulder since 1 year.she had h/0 swelling of metacarpel joints (left hand ) which goes away after treatment but stiffness persisted. She also mentioned morning stiffness in all over body for 15-20 min. Now she has same complaints started on right and shoulder in moderate proportion. Patient has history of kochs 2 yr back (completed treatment). Atrophy and contracture of left hand is visible in image. She also has c/0 insomnia since 2-3 yr for that she takes ativan 2 mg Hs. Serum Uric acid was normal Now patient came to me.... Plz guide with probable/differential diagnosis and funther line of treatment?

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Concluded answer

Rheumatoid arthritis. Also rule out Hyperurecaemia

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? PEREPHERAL ARTHROPATHY .. ? GOUT.. NEED'S.. CLINICOPATHOLOGICAL EVALUATION WITH EXPERTS OPINION.. MEANWHILE TREAT SYMPTOMATICALLY.. WITH.. ETEROCOXIB 90MG OD.. DEFLAZACORT 12MG OD.. MULTIVITAMINS ANTIOXIDANTS..

Can it be rheumatoid arthritis?
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