Concluded Case

nodular RA turned out to be a case of felty's syndrome.

young female, presenting with complaints of swelling pain and redness over small joints of hands and bilateral knee joints since last one year. symptoms increases in winter. on examination there are nodules over dorsum of hand with joint deformity of metatarsophalyngeal joints. malar rash is present. no hypersensitivity to sunlight.

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Concluded answer

it turned out to be a case of felty's syndrome with chronic lgl leukemia. Pt had hypersplenism, neutropenia and nodular RA.

All Answers

Most probably of Rheumatoid Arthritis. Cold temperature Much needed the investigations. Agree to Dr.Ramesh Kumar Sir

Thankyou sir. RA factor is negative, ANA is awaited, ESR is 20mm/1st hr. CRP is positive.
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SLE , RA, are DD ANA profile, RA, ESR, CRP, ACCP antibodies to be done . If SLE, steroids are needed. If RA , DMARD s are needed ECHO to be done to rule out rheumatic Valvular heart disease

Rheumatic arthritis ask for CBC ESR Blood SUGAR LFT RFT RE URINE URIC ACID, RA FACTOR, CRP

Tanks sir. Her TLC is 8000, hb 13.4gm/dl, RBS is 70 mg/dl, RA factor neg, CRP is positive. Rest of the investigations reports awaited.
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First get her investigated for S.Uric acid anx R A titre..

Rheumatoid arthritis cold stress

Thank you doctor
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Going by then details looks to be a case of sle Get ana done And for the joint involvement treat with HCQS 200mg BD METHOTREXATE 7.5 once a week Wasoolne according to the weight and taper accordingly Once ANA is done go for anti dsDNA For sle

Thanks doctor. She is already on methotrexate and HCQS. ANA is awaited.
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Rheumatoid arthritis Go for RA factor , uric acid level

Rheumatoiid Arthritis Gout

SUGGESTIVE OF . S. L. E FELTY'S SYNDROME DD R. A NEEDS. FURTHER. EVALUATION

Thank you doctor
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Seronegativ R.A. Check S.Uric acid

Uric acid level 4.4 mg/dl
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