Concluded Case

Nyc answer

An 80-year-old woman presents to her general practitioner (GP) with pain and swelling in her left knee. The pain began 2 days previously and she says that the knee is now hot, swollen and painful on movement. In the past she has a history of mild osteoarthritis of the hips. She has occasional heartburn and indigestion. She had a health check 6 months previously and was told that everything was fine except for some elevation of her blood pressure which was 172/102 mmHg and her creatinine level, which was around the upper limit of normal. The blood pressure was checked several times over the next 4 weeks and found to be persistently elevated and she was started on treatment with 2.5mg ben- drofluamethizide. The last blood pressure reading was 138/84 mmHg. There is no relevant family history. She has never smoked and her alcohol consumption averages four units per week. She takes occasional paracetamol for hip pain. Examination Her blood pressure is 142/86mmHg. The temperature is 37.5°C and the pulse 88/min. There is grade 2 hypertensive retinopathy. There is no other abnormality on cardiovascu- lar or respiratory examination. In the hands there are Heberden’s nodes over the distal interphalangeal joints. The left knee is hot and swollen with evidence of effusion in the joint with a positive patellar tap. There is pain on flexion beyond 90 degrees. The right knee appears normal.

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Concluded answer

Hot, swollen, pain on movement more than 90* suggestive of active inflammation of joint... History of vigorous activity , standing etc 2 days prior ? If no other infective markers positive, it can be considered active inflammation of affected osteoarthritic knee... Check for TFL tightness due to weakness of glutei muscles affecting the knee joint... Rest, ice, elevation, static quadriceps, TFL relaxation, gentle joint mobilization should relieve the active symptoms..

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? KNEE ARTHROPATHY .. ? OA ..

How it's arthropathy ?? Can explain ??
0

Age related OA knee bilateral Symptomatic knee could be having an acute exacerbation More importantly rule out joint sepsis Synovial fluid gramstain and culture CBC esr

Hot, swollen, pain on movement more than 90* suggestive of active inflammation of joint... History of vigorous activity , standing etc 2 days prior ? If no other infective markers positive, it can be considered active inflammation of affected osteoarthritic knee... Check for TFL tightness due to weakness of glutei muscles affecting the knee joint... Rest, ice, elevation, static quadriceps, TFL relaxation, gentle joint mobilization should relieve the active symptoms..

Thank you doctor
1

Adv MRI knee joint. Consider Knee OA

@typical grade 1 tibiofemoral oa, icing should be done atleast twice a day, along with that gentle mobilization in terms of static quads and ankle toe, once pain starts decline, slr, high sitting and terminal knee extension to be started strict avoidance of squatting and crossed legged sitting patient may use knee cap for walking and stair climbing also rule out deficiency of calcium and/or vit d3

Thank you doctor
1

Tab Glucosamine continu

Old age with osteoarthritis with osteoporosis mild HT With Gastritis .

Physiotherapy treatment and meditation

Annagesic n antibiotics n hinged knee brace

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