70 yr old female patient ....
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. 70yr old female came to OPD C/O loose stools since 10 days and two episodes of vomiting 10days ago. lower back pain and blebs over dorsal aspect right lower limb along with swelling since 20 days. Patient was asymptomatic for 15yrs back. 15yrs back H/o fever - on check up found to have HTN 10 yrs back joint pains were developed first to distal small joints ,elbow joint and now many joints are involved ( pt do not have an idea about the sequence of joints involved in pain after that) 8 yrs back pt found that aggravated joints pains went to a local hospital and started to