A case of joint pain

Chief Complaint A 78 y/o female complains of pain in b/l hips, knees, and hands for 3 years. She complains of difficulty in walking and getting up from sitting along with low back pain. Today she could not get up from the floor. History No history of arthritis or osteoporosis. Past medical & surgical history non-contributory. Vitals BP: 140/80 mmhg, Pulse: 75 bpm, Resp rate: 17 bpm, Temp: 98.5 degree F Investigations No numbness or swelling on joints. Neurological examinations normal. Gait slow & stiff. Decreased range of motion in hands. Decreased flexion and extension in back. Hips have decreased ROM with internal/external rotation. Knees enlarged with decreased flexion/extension and crepitation present bilaterally; right greater than left. Diagnosis What is the diagnosis? Treatment How should the patient be managed?



Perthes disease??? Exercise and medication and physiotherapy. Analgesic, anti inflammatory and steroids is very important to the patient. X - Ray, CBC, CALCIUM VIT- D, test essential.

Sir investigat RA factor, Uric acid , BSL ,-X ray of affected joints . Start ,Tab Etos 60 mg BD Tab Ultracet -HS Tab Neurobian forte -BD Tab Pantocid 40 - OD empty stomach

Rt. Knee Severe osteoarthritis than left knee You should have to go for B.sugar Looks profile Uric acid RA factor & x ray of B/L knee joint & if severe OA then treatment is only TKR

D/d lumbar region radiculopathy if No OA

Sounds like OA Xray pelvis with both hips Xray both knee Xray lumbosacral spine

Dear @Dr. Mukesh Bhalla (pt) Its a case of Sciatica and Rheumatic Arthritis, refer the patient to Ayurvedic or Homoeopathy consultant for permanent treatment, thank you

Dear Dr Bhalla,in 70 yrs of age it is miracle that pt has no h/o OA or RA ,please rule out MRI L/s spine for LBA,RA factor and serum Uric Acid with x ray both hip AP veiw to get some findinsl of both hip joints.. Till pt should be taken Tab Nucoxia 60 1bd Tab Pan 40 1 od. Cap uprise D3 60 k 1 weekly Tab Pregablin+methycobalamine 1500mcg. Tab Medrol 4 mg 1bd

DD. Sacro iliac sprain, 2. Lubosacral spondylolisthesis 3. Hyper urecaemia.

Go for some basic investigation like blood and radiological ..that will help you to manage well

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