Pt. 53/F, C/O pain n jt stiffness in B/L hands n feet since 7-8 yrs. H/O chicken gunia fever 7-8 yrs ago. O/e, stiffness of MCP pIP n dIP jts of both hands. Ankle n MTP jts stiffness. Clinical pic n ixns attached. Advise, Dx n rx plz.

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here i see 4 reasons of joint pain 1.chikungunya..some chikungunya patients have joint pain for years but stiffness of mcp joints and pic rules that out 2.. Urinary tract infection but again ruled out due to above reasons 3. Gout as normal level for females in 5.5 4. Rh.Arthritis seems most apparent diag. Do Anti. ccp an start mefications only after u get reports

uric acid may be normal in gout
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Do anti ccp as well as rule out infective arthritis. Urine culture for selecting antibiotics.till you treat symptomatically Ultracet sos for pain vit C 500 mg ; Alkaline agents (Urikind or alkasol)sos.pt to be adv for drinking plenty of water

Thank u sir. Will snd for anti ccp
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CLINICALLY IT APPEARS TO BE RA WITH UTI DO ANTI CPP &URINE C&S TEST.TREAT SYMPTOMATICALLY TILL THE REPORT COMES.

Thank u sir
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raised ESR and CRP :active disease The differential diagnosis includes: viral arthritis (e.g. parvovirus, rubella, hepatitis B) reactive arthritis (e.g. post-infection: throat, gut, sexually acquired) seronegative spondyloarthropathy (e.g. psoriatic, ankylosing spondylitis, Reiter's disease, inflammatory bowel disease) connective tissue disease (e.g. systemic lupus erythematosus, scleroderma) polymyalgia rheumatica polyarticular gout osteoarthritis septic arthritis fibromyalgia medical conditions presenting with arthropathy (e.g. sarcoidosis, thyroid disease, infective endocarditis, haemochromatosis, diabetic cheiroarthropathy, paraneoplastic syndromes, multiple myeloma)

Rheumatoid arthritis, start indomethacin 75mg sr od, tab sallaki 400mg bd for 10 days, do anti ccp, dsdna to confirm RA. Can add amoxicillin potassium clavunate 625 bd, rejoint uc , cap glace x od

Thnx sir
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प्रथम रोगी का पंचकर्म करें। तत्पश्चात चिकित्सा करें।वातचिंतामणि स्वर्ण युक्त 1 रत्ती। योगेन्द्र रस 1 रत्ती भर शहद मिलाकर सुबह-शाम सेवन कराएं। महारास्नादि क्वाथ को 25 ग्राम सुबह-शाम सेवन कराएं।महानारायण तैल की मालिश करें। निश्चित रूप से लाभ होगा योग परिक्षित है पिछले 40 वर्ष से प्रयोग कर रहा हूं

आयुर्वेद के अनुसार रोगी गठिया से पीड़ित है। चिकित्सा संबंधी योग,,,, छोटी हरड़ को तवे पर देशी घी में भूनकर चबा चबाकर खाएं और फिर ऊपर से ताजा गिलोय का काढ़ा बनाकर पीने को दें। माजून सुरनजान 5 ग्राम माजून फनफसा 5 ग्राम दूध के साथ सुबह शाम सेवन कराएं। चिकित्सा लम्बी चलेगी। निश्चित रूप से लाभ होगा। योग परिक्षित है। पिछले 40 वर्ष से प्रयोग कर रहा हूं।

Clinically, it appears to be a case of Rheumatoid Arthritis, and needs management accordingly.

Sir after doing .anti CCP and ana And doing initial pain management ...put her on ayurvedic medicine .she will definitely improve well... As we can not extend long term treatment with methotrexate, indomethacin and other immunosupprest and dmrd drugs.

Thnx. Which meds do u usualy use in such cases n for how long
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MIGRATORY ARTHRITIS

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