55 yr old Female with c/o chestpain

 NOTE:THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS / HER /GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT.

CHIEF COMPLAINT: C/O chest pain, pain in the left sacroiliac and knee jt. and urinary inconsistence.

PATIENT HISTORY: A 55 yr old female who is a housewife, visited out hospital on 10/02/22. She has a history of sudden onset of chest pain for the last 10 years, 2 - 3 episodes almost regularly with each episodes lasting for around 5 - 15 mins, sometimes for 30 mins also. She described her chest pain to be sudden sharp pinpoint chest pain in the center of her chest, exaggerated after lunch and dinner mostly, sometimes would radiate to her left side. NO SOB or sweating. She 10 years ago got her heart checked up in Bombay( when she went there for routine check up for her husband's oral cancer ), but nothing abnormal was found. She complained that this chest pain was severe for the last 7 years, after which she gave up her addiction of milk tea(2 - 3 cups daily morning and evening) and for the past 3 years her chest is less severe. She still continues to have fried, oily and spicy food as evening snacks, but little less that what she used to have for the last 7 years. For the past 8 - 10 years continuous and intense pain in her left side Sacro iliac jt. everyday, exaggerated while long standing, getting up from sitting position or while getting up from bed and during winter. While getting her husband's checkup in Bombay, she was advised to wear belt for her lower back pain. She said that she do not wear belt  Wears belt time to time only when pain exaggerates.  7 - 8 years  ago she had an episode of knee pain and swelling along with her feet which lasted for 4 months. She did Allopathy( 10 - 15 days ) and then homeopathy ( 3 - 4 months ) after which her knee and feet pain with inflammation reduced significantly. 2 - 3 years back she again started c/o knee pain and inflammation(continuous) along with ankle pain(sometimes). Walking do not increase her knee pain either. For the past 5 - 6 years c/o urinary incontinence. 1 year ago c/o burning micturition with itchiness and inflammation for which used cream on Physician's advice for 7 - 8 days after which itchiness and inflammation resolved. 2 - 3 months ago visited clinician to treat urinary incontinence. Took medication for 15 days after which pt. feels better than before. No history of HTN, DM.

PERSONAL HISTORY: She goes for morning walk(1 km ) everyday. Does all household chores from washing clothes, cleaning utensils to cooking.

FAMILY HISTORY: Her mother(75 yrs) developed lower back pain and knee jt pain in her old age(from 65 yrs). Her father( 85 yrs) was an alcoholic and had a history of TB at the age of 35 yrs.

TEST REPORTS





ECG


X rays



FINAL DIAGNOSIS: Grade 2 -3 sacroiliitis, Spondyloarthropathy















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