Whole body edema Non pitting

Female patient of age 56 comes in opd with compalin of abdominal pain mild Whole bodyache and swelling Chief Complaints Body and joint pain Edema Weakness Sleeplessness History History of taking medication for pain And same condition since long from various hospitals Vitals Bp:130/84 Pulse:88 Physical Examination Weak Overweight Heavy body Non pitting generalised edema Investigations Investigation attached in pdf Management Need to be discussed

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Most likely steroid abuse for long standing arthritis , edema and glucose intolerance and body habitus likely due to steroid abuse To rule out rheumatoid arthritis or needs arthritis work up , get CRP , RA factor and if history strongly suggestive of Rheumatoid arthritis go for antiCCP antibodies Anemia mostly of chronic disease , likely RA in this case Supplement calcium and Vit D at present Get proper arthritis history and workup , and proper drug history

Severe anemia with vid d deficiency....inv hb electrophoresis must be done

NSAID related oedema,iron deffieciency anemia, bit d3defficiency +obesity

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