36 yr old female with severe joint pain and pitting edema

 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.

PATIENT HISTORY: The patient is a 36 yrs old housewife. 

Since childhood, she has had a history of falling sick with mild fever, cough, and cold with a headache. Symptoms would last for 2-3 days and resolve with allopathic medicines. This used to happen 1-2 times/yr, especially during winter. 

5-7 yrs ago, she c/o dry cough lasting for 1 wk to 10 days almost every month.

4-5 yrs ago, she c/o of itchy skin (pruritic rashes) which stayed for 1-2 days and went away after taking medicines.

1 yr ago, one day she c/o lightheadedness and blurry vision. Dr. diagnosed the symptoms to be due to HTN. Is using medicines for the same.

Pt is non-diabetic. She has been chewing paan (5-7 times) for more than 15 yrs. 

CURRENT CHIEF PROBLEMS  AND PATIENT'S REQ.: 5 months ago, she noticed pitting edema in her legs for the first time. 

2 months ago, she started c/o multiple small and large joint pains symmetrically involving jt of the big toe, ankle jt, knee jt, interphalangeal jt of hand, elbow jts, especially after getting up from bed. The jt pain is a non-migrating type i.e happens in different joints at the same time. She c/o that the pain is very intense, especially after waking up in the morning, and decreased somewhat as the day progresses. But pain stays all the time. The pain intensity is increasing for the past 2 months. It has affected her daily life chores like sweeping the courtyard of her home or washing clothes. Cannot walk or stay standing for long because of pain.

FAMILY HISTORY: No one in her family has any similar complaints. No one has diabetes or HTN.






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