45 year old female with wrist joint pain and ankle joint pain since 4 years

- April 14, 2023

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Chief complaints:-

C/O right and left wrist and ankle joint pain since 4 years

C/O neck pain since 4 years

C/O generalised weakness and difficulty in lifting weights since 4 years

History of present illness:-

Patient was apparently asymptomatic 4 years back and then patient developed joint pains such as wrist and ankle joint pains which is insidious in onset gradually progressive,dull aching type of a pain, associated with early morning stiffness lasts for 2 hours

Pain aggravates relatively at end of the day, associated with fever- low grade not associated with chills and rigor on and off since 4 years

Patient also complaints of small joint pains such as metacarpo phalyngeal joints and proximal inter phalyngeal joints of both the upper limbs

C/O pain in the back of the neck which is insidious in onset gradually progressive,dull aching type of pain, radiating to the occipital region and shoulder since 4 years.

C/O tingling sensation of both the soles since 2 years

C/O lower back ache on and off since 4 years

No h/o large joints involvement like knee,hip,elbow and shoulder joints.

No h/o any trauma.

No h/o nausea and vomiting.

No h/o sob,chest pain and pedal edema.

No h/o burning micturition and decreased urine output.

Past history:-

N/K/C/O DM, HTN, TB, Asthma, epilepsy, CVA,CAD, thyroid disorders.

Personal history:-

Diet: mixed

Appetite : normal