Concluded Case

Pain in shoulder nd elbow

56 yr old male present(sedentary lifestyle) with • pain in Left shoulder & elbow and Right elbow since 2 months •CRACKING sounds at left shoulder during movements •pain is INCREASED during bath with COLD water •NO movement restrictions •no significant sytemic history what is probable Dx and T/t?

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Concluded answer

Shoulder likely to have periarthritis with subacromial impingement Xrays needed Multiple joint involvement need evaluation for inflammatory arthritis CBC esr RA factor Uric acid Crp Analgesics Chymoral Physiotherapy

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Along with the test of blood profile in the mean of URIC ACID CCP VIT D Cervical x-ray also needed may be there is nerve compression.so it will be ruled out through x ray...Sometimes the symptoms of cervical spondylitis may differ with pts.it will help to rule out either there is only joint related isssue or with the involvmen of nerve also.Nd started physio as early as possible...

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Pt is living sedentary life and of 56 yrs of age suggest he must be obese and overweight and may be having comorbidies like diabetes hypertension Since multiple joints are involved needs detail investigations xrays of joints and blood investigations like RA factor anti ccp Cracking sound in lt shoulder joint suggest OA lt shoulder NSAIDs Vitd3 Physiotherapy

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? Cervical spondylitis ? Cervical nerve root compression ? Muscle sprain. ? Local/bony injury. Suggest. MRI. Of next with Left shoulder. Tab. Myospas Forte. 1bd Tab. Neurokind Gold. Od Tab. Pan 40. Od B/F. Locally. Hot formentation and Dyaper gel application

Shoulder likely to have periarthritis with subacromial impingement Xrays needed Multiple joint involvement need evaluation for inflammatory arthritis CBC esr RA factor Uric acid Crp Analgesics Chymoral Physiotherapy

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Polyarthritis.. of large joints... DD:- Vitamin D deficiency; Hyperuricemia, Autoimmune arthritis. (RA or Sjogren). Tt:- evaluate for deficits and ANA profile. Start with Naproxen or Etoricoxib for pain relief.

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Bursitis due to repeated stress on left shoulder And likely to be tennis elbow Rule out for cozen's test Rest milli's manipulation

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Disuse Atrophy of all joints due to sedentry life style Arthritis has developed in all joints Advised physiotherapy Nsaid orally

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Frozen shoulder with tennis elbow dd oa dd bursitis mri

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periartheritis

Osteoarthritis both shoulder Tab Etoroxicib 90mg twice daily Diclofenac gel locally Shoulder exercises SWD

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