A 36-year-old woman presented with severe pain in B/l hands, elbow joint and feet. She is unable to do daily tasks due to this pain. There is also associated morning stiffness in multiple joints for more than 45 minutes. On examination; Active bilateral synovitis in her hands, wrists, and ankles, and nodules on her left elbow. Tenderness ++ (b/l hands and elbow joint) Movement- Restricted in almost all small joints of body due to pain. Her laboratory results were as follows: C-reactive protein (CRP) = 5.7 mg/dL (normal: 0.1–0.9 mg/dL), ESR = 38 mm/h (normal: 0–15 mm/h) Rheumatoid factor (RF) = 344 (normal: 0–29 IU/mL), CCP = 90 (normal: 0–20). Other parameters within normal She is kapha vata prakriti, agni bala avara, Mala pravritti is saama baddha mala.

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Hello I read case,is there any redness on joints? Here CRP is normal so it may looking chronic.. It's seen like kaphavrut vat, if pitta is involved then go for shaman chikitsa. If no redness then do Valuka potalli swedam for 7days following Patrapotali pinda swedam and then Matra basti for 7day along with dipan,pachan dravya with satmya aahar. So treat Aama first. Thanks.
Advise Langhan as per bala Panchkol churn/ peya..As it has dipniya and shulaghna properties Erand bhrust haritaki churn 3 to 5 mg bd according to koshtha Sinhnad gugulu If possible give nadi or bashp swedan for 3 days You can give viataran basti too
Nodular Artheritis Simhanad Guggulu Aamvaatari Rasa Rasnasaptak Kwatham Mouktika Kamdudha Rasa Avipattikar Churna Drink Eranda Tailam 2-3 Drops In Cup Of Milk HS Vaaaluka Or Eranda Patra Swedanam
Kaishore guugulu with saarivadyasava Amrita+ sunthi +dhanyak kwatha 20ml BD Pipala twak kwatha Eranda tail with guduchi at night Dalchini+Sunthi lepa daily for 1 Month
स्टॅफिसाग्रिया 200,कॅल्के.आयोडेट 6

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