CASE DISCUSSION

A 50 YEAR OLD FEMALE  A 50 year old female came to the OPD with   CHIEF COMPLAINTS-  Pain   Stiffness in several joints since three months HISTORY OF PRESENTING ILLNESS- Patient was apparently asymptomatic 10 years ago then she developed a dull aching type of pain and stiffness in her metacarpophalangeal joints in her right hand associated with limitation of movements at the joint . Then within 6 months of the onset of the disease, it has progressed to involve other joints of the right hand,left hand as well as wrist and elbow joint   Then within 4 years of onset she started feeling pain in the joints of feet and ankle   Since 3 months the pain  became unbearable limiting her activities . PAIN  was insidious in onset,slowly progressive,dull aching type of pain,non radiating,associated with swelling ,stiffness and limitation of movements in the involved joint.       STIFFNESS and PAIN was more in the first one hour of waking up and gradually improved with movements   There are few exace

"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 available 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  CASE OF MULTIPLE SKIN LESIONS  A 23 year old lady , psychologist by occupation resident of nalgonda came to opd with c/c of painful skin leisions over the upper and lower limbs and back of trunk since 8 months  HISTORY OF PRESENT ILLNESS: Patient was apparently assymptomatic 8 months back she developed multiple red lesions on both upper limbs not associated with burning or itching after 1 week she developed itching and burning then she consulted local doctors who prescribed some medications but leisi