Question

A 56-year-old woman presents to her doctor's office complaining of gradually progressive, nonpainful enlargement of the terminal joint on her left hand over a 9-month period. She has some stiffness with typing but not first thing in the morning. She also reports pain in her right knee, which occasionally "locks up." The right knee also hurts after long walks. On examination, her blood pressure is 130/85 mm Hg, heart rate is 80 bpm, and weight is 285 lb. Examination reveals only a nontender enlargement of her left distal interphalangeal (DIP) joint, and the right knee is noted to have crepitus and slightly decreased range of motion. There is no redness or swelling.

Questions
What is your next step?

What is the most likely diagnosis?

What is the best initial treatment?

Answer 1

The patient is suffering from the obesity. She might have joint disease and but no synovitis is diagnosed in her medical examination.

1) The next step is the determination of the erythrocyte sedimentation rate. This step measures the speed of the sediment of erythrocytes. The high sediment rate may be indication of the infection of the auto immune disease.

2) The most likely diagnosis of the patient is osteoarthritis. This causes the condition of joint paints and affect the million of the people in the world.

3) The initial treatment might be given to the patient is NSAID (Nonsteroidal anti-inflammatory drugs). These drugs are taken to remove the pain and generally prescribed to the medical condition of the patient of arthritis.