#OstioArthritis

67/Female with Severe pain in Knee Joint Treated with Analgesics but not Resolved Kindly Give ur suggestions

54 years old female. it's a complaints of severe pain both knee joints especially left knee. there is too much swelling in right knee. intensity of pain is always same that is during rest ,sitting, and movement.she also complaints of a nervine pain from lumber to ankle joint increasing during breast in left leg. she is taking so much allopathic pain killers since last 6 years without any cure. your diagnosis management and medicine please.

#HolisticMedicine #CCA update Arthritis is very common but is not well understood. Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions. People of all ages, sexes and races can and do have arthritis, and it is the leading cause of disability in America. More than 50 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people get older. Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years, but may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints. There are different types of arthritis: Degenerative Arthritis Osteoarthritis is the most common type of arthritis. When the cartilage – the slick, cushioning surface on the ends of bones – wears away, bone rubs against bone, causing pain, swelling and stiffness. Over time, joints can lose strength and pain may become chronic. Risk factors include excess weight, family history, age and previous injury (an anterior cruciate ligament, or ACL, tear, for example).  When the joint symptoms of osteoarthritis are mild or moderate, they can be managed by: balancing activity with rest using hot and cold therapies regular physical activity maintaining a healthy weight  strengthening the muscles around the joint for added support using assistive devices  taking over-the-counter (OTC) pain relievers or anti-inflammatory medicines avoiding excessive repetitive movements If joint symptoms are severe, causing limited mobility and affecting quality of life, some of the above management strategies may be helpful, but joint replacement may be necessary. Osteoarthritis can prevented by staying active, maintaining a healthy weight, and avoiding injury and repetitive movements. Inflammatory Arthritis A healthy immune system is protective. It generates internal inflammation to get rid of infection and prevent disease. But the immune system can go awry, mistakenly attacking the joints with uncontrolled inflammation, potentially causing joint erosion and may damage internal organs, eyes and other parts of the body. Rheumatoid arthritis and psoriatic arthritis are examples of inflammatory arthritis. Researchers believe that a combination of genetics and environmental factors can trigger autoimmunity. Smoking is an example of an environmental risk factor that can trigger rheumatoid arthritis in people with certain genes. With autoimmune and inflammatory types of arthritis, early diagnosis and aggressive treatment is critical. Slowing disease activity can help minimize or even prevent permanent joint damage. Remission is the goal and may be achieved through the use of one or more medications known as disease-modifying antirheumatic drugs (DMARDs). The goal of treatment is to reduce pain, improve function, and prevent further joint damage. Infectious Arthritis A bacterium, virus or fungus can enter the joint and trigger inflammation. Examples of organisms that can infect joints are salmonella and shigella (food poisoning or contamination), chlamydia and gonorrhea (sexually transmitted diseases) and hepatitis C (a blood-to-blood infection, often through shared needles or transfusions). In many cases, timely treatment with antibiotics may clear the joint infection, but sometimes the arthritis becomes chronic. Metabolic Arthritis Uric acid is formed as the body breaks down purines, a substance found in human cells and in many foods. Some people have high levels of uric acid because they naturally produce more than is needed or the body can’t get rid of the uric acid quickly enough. In some people the uric acid builds up and forms needle-like crystals in the joint, resulting in sudden spikes of extreme joint pain, or a gout attack. Gout can come and go in episodes or, if uric acid levels aren’t reduced, it can become chronic, causing ongoing pain and disability. Diagnosing Arthritis Arthritis diagnosis often begins with a primary care physician, who performs a physical exam and may do blood tests and imaging scans to help determine the type of arthritis. An arthritis specialist, or rheumatologist, should be involved if the diagnosis is uncertain or if the arthritis may be inflammatory. Rheumatologists typically manage ongoing treatment for inflammatory arthritis, gout and other complicated cases. Orthopaedic surgeons do joint surgery, including joint replacements. When the arthritis affects other body systems or parts, other specialists, such as ophthalmologists, dermatologists or dentists, may also be included in the health care team.

This 81 year old lady who's with HTN, DM-2, DKD with creats at 1.5-1.7, DM neuropathy, OA B/L Knees, Hypothyroidism who's compliant with her treatment came with Dysuria. Culture revealed only Piperacillin, Ceftazidime, Meropenam., No oral forms of Antibx As the patient has refused the admission, I've started on Faropenam 200 BD and Gabaneuron-NT (as her neuropathy was so severe even with 150 mg of Pregabalin) After 2 days of Faropenam, 1 day of Gabaneuron-NT, she's developed the swelling of tongue (which is otherwise normal, without itching or burning or pain) Don't know if I should attribute it to the drugs which she's started on. Her labs were satisfactory FBS 98 PPBS 127 A1C 7.2 FLP, LFTs, Electrolytes are normal B urea 42 S Creatinine 1.6 TSH 5.5 (T3, T4- Nml) Mild Normocytic to microcytic Anemia (10.4-Hb) Vit D3, B12, Urine Methylmalonate are normal She's on Sitagliptin 25mg OD Telma 40mg OD Atorva 10mg OD Dytor 10mg OD Thyroxine 75mcg cm Montelukast-Acebrophylline OD Salmetrol with Fluticasone MDI Twice a day Calpol-T for pains SOS Vit D3 60k weekly Colchicine 0.5 OD for her OA These are her long-term meds., the new additions as mentioned being Faropenam, Gabaneuron-NT

THIS 50 YR MALE C O --SWELLING AND SEVER PAIN ON LEFT KNEE ONLY NO C O FEVER NO H O TRAUMA AND PULMO KOCHS AND PSOARIASIS LIKE DISEASE ALL SYSTEMIC EXA ARE NORMAL BP 130 80 RBS 122 RANDOM NO PALLOR X RAY IS ADVISED BUT PATIENT REFUSING WHAT MAY BE THE CAUSE AND MANAGEMENT