tbl joint pain
DESCRIPTION
-TRANSCRIPT
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TBL : JOINT PAIN
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Case Scenario
Name :
Age : 25
D.O.A : 7 / 4 / 2015
Chief complaints- Joint pain for 3 years - Diarrhea for 3 weeks
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History of Presenting Complaint• Joint pain – bilateral , symmetrical
polyarthritis affecting the small joints of the hand and feet , wrists , elbows , shoulders , hips , knees and ankles
• Associated with joint swelling – relieved with prednisolone
• Morning stiffness - lasting more than one hour. • Painful mouth ulcers • Occasional hair loss • Fatigue – often feels tired and sleepy.
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• No history of trauma or injury
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Systemic Review
• General : Loss of weight by 3 kg over the past 3 months.
• CVS :• Respi : No cough , no S.O.B • Renal : Frothy urine , no haematuria , no
dysuria
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Past Medical History
- Admitted to HTJ Seremban in year 2012 due to pleuritic chest pain.
- Underwent blood tranfusion in November last year.
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Drug History
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Investigations
a) Full Blood Count
WBC
RBC
Hb
Hc
MCV
MCH
MCHC
Neutrophil
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b) Renal Function Test
Urea Creatinine Albumin Total proteinBilirubin
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c) Coomb’s Test : Negative
d) ESR : 60 mm/hour (INCREASED)
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Management
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Clinical Features
Serositis
Oral ulcers
Arthritis
Photosensitivity
Blood disorder
Renal disorder
ANA positive titre
Immunological disorder
Neurologic disorder
Malar rash
Discoid rash
Remember the mnemonic SOAP BRAIN MD !!!