A 50 years old male came to casuality with knee pain

March 19, 2022

This is an online E log book 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 series of inputs from avakeilable global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. 

This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment .


A 50 years old male who is a farmer came to casuality with knee pain since 1 year. The pain was insidious in onset and is gradually progressive. 

HISTORY OF PRESENT ILLNESS :-

Patient was apparently asymptomatic 4 years back. Then he developed knee pain. The pain was insidious in onset and is gradually progressive. He has severe knee pain and pedal edema since 6 days and was admitted in the hospital. He was diagnosed with hyperuricemia and anemia under evaluation. 

He has no history of diarhoea and vomitings. 
He has no history shortness of breath. 

HISTORY OF PAST ILLNESS :-

No history of alcohol and smoking. 
No history of hypertension and diabetes mellitus. 

PERSONAL HISTORY :-

Diet - mixed
Sleep - normal
Appetite - decreased
Addictions - no history of alcohol
Allergies - no allergies

FAMILY HISTORY :-
 
No relevant family history. 

GENERAL EXAMINATION :-

Patient is examined under well lit room amd adequate ventilation with his consent taken. 

Patient is conscious, coherent and cooperative, well oriented to time space. He is moderately built and well nourished. 

No visible pallor, icterus, cyanosis, clubbing, lymphadenopathy. 
History of pedal edema since 6 days. 

Vitals :-

Temperature - 97.6°F
Blood pressure - 100/60 mm hg
Pulse rate - 74 bpm
Respiratory rate - 18
Spo2 - 97%
GRBS - 105 mg%

SYSTEMIC EXAMINATION :-

Cardiovascular system -
S1 and S2 sounds are heard. 
Respiratory system -
Bronchial artery embolisation. 
Central nervous system -
No neurological defects. 

INVESTIGATIONS :-

    Ultrasound scan report :
  

   Ecg :
  

    Blood urea :
    
    
   Serum creatinine :
  
 
   Serum electrolytes :
   
    Colour doppler 2d echo :
    
    Hemogram :-
TREATMENT :-

Inj Pan 40 mg IV/OD
Inj Monocef 1gm IV/BD
Tab Col
Tab Prednisolone 40mg BD
Inj Kenacortin 40mg IM
Tab Methotrexate 7.5 mg
Tab Folvite 5mg

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