Rheumatology Online Doctors Consultation

Patient Name: Anannya Chatterjee Age: Not mentioned Complaint: Multiple joint pain (finger joints, wrist, shoulders, knees, heels) with worsening knee pain at night and morning joint swelling. Duration: 2 years Provisional Diagnosis: Suspected Inflammatory Arthritis (e.g., Rheumatoid Arthritis, Psoriatic Arthritis, or others) / Autoimmune etiology Recommended Diagnostic Tests: Blood Investigations: Rheumatoid Factor (RF) Anti-Cyclic Citrullinated Peptide (Anti-CCP) Antibody Erythrocyte Sedimentation Rate (ESR) C-Reactive Protein (CRP) Complete Blood Count (CBC) Vitamin D3 Serum Uric Acid Thyroid Function Test (T3, T4, TSH) ANA (Antinuclear Antibody) Panel HbA1c (if not done in the past 6 months) Imaging (as needed based on symptoms): X-ray of affected joints (hands, knees, etc.) Ultrasound or MRI of joints (if swelling or synovitis is suspected and plain X-ray is inconclusive) Temporary Symptomatic Relief Medications (Short-Term Use Only): Tab. Paracetamol 650 mg – 1 tablet every 6-8 hours after food if pain is severe. (Max 3/day) Tab. Aceclofenac 100 mg + Paracetamol 325 mg – 1 tablet after food twice daily for 5 days. (Only if Paracetamol alone is ineffective and no gastric issues) Cap. Pantoprazole 40 mg – 1 capsule daily before breakfast to protect stomach while on painkillers. Topical Application: Diclofenac gel – Apply on painful joints 2–3 times daily. Supportive Measures: Warm water compress on painful joints (especially knees and shoulders). Gentle stretching and low-impact exercise (like swimming or yoga, as tolerated). Use orthopedic footwear or cushioned slippers for heel pain. Elevate legs with a pillow at night if swelling is present. Advice: Avoid excessive joint strain or heavy lifting. Keep a pain and swelling diary to help your doctor assess triggers and progression. PLEASE MENTION YOUR AGE . ALSO SEND ME ANY REPORTS YOU HAVE OR TAKING ANY MEDICATIONS. YOU CAN GET PAID CONSULTATION HERE OR CONTACT ME ON WHATSAPP. THANK YOU DR Shayeque Reza MD 9800280276

Hello anannya by looking at your symptoms and duration it's most probably RHEUMATOID ARTHRITIS. Get blood investigations like 1. RA factor 2. Anti CCP antibodies 3.CBC 4.ESR,CRP, S. URIC ACID Now for pain take Tab. Etoricoxib 1-0-1* 5 days after food Tab. Pan 40 1-0-0* 5 days beforehand food. Tab. Methyl prednisolone 8mg In tapering dose after getting your diabetic profile done. If diabetic steroids are not advisable* After these investigations consult a rheumatologist If any doubts dm me.

Hello Nitin, For your knowledge I wanna state that there is no proper study that cholecystectomy can raise your uric acid. Do you any of these symptoms: Sudden joint pain/swelling (especially in feet or toes) Red, hot, stiff joints (classic gout attack) Kidney stone symptoms: back pain, blood in urine, frequent urination

Are you on any medications? If not start DMARDS like HCQ 200mg, MTX 7.5 mg once weekly along with supplements. BUT IT'S MANDATORY TO GET BLOOD INVESTIGATIONS ( LFT,RFT) BEFORE STARTING THESE TABLETS. FOR NOW if not DIABETIC start course of steroids in tapering dose. For pain now can take tab piroxicam 1-0-1* 5 days

Dear Harleen, I understand your concern about your mother’s arthritis and the recent issue with her right hand’s last two fingers not working properly. While arthritis is often a chronic condition requiring lifelong management, new symptoms like finger dysfunction may indicate additional complications that need further evaluation. Possible Causes of Finger Dysfunction 1. Arthritis Progression – If your mother has rheumatoid arthritis or osteoarthritis, joint deformities or inflammation can affect finger movement. 2. Nerve Compression (Ulnar Nerve Palsy) – The last two fingers are controlled by the ulnar nerve, which can get compressed at the elbow (cubital tunnel syndrome) or wrist (Guyon’s canal syndrome), causing weakness, numbness, or difficulty moving these fingers. 3. Tendon or Ligament Issues – Chronic arthritis can lead to tendon damage, making it hard to move certain fingers. 4. Cervical Spine Issues – If there’s nerve compression in the neck (cervical spondylosis), it can lead to hand weakness or numbness. Next Steps & What You Can Do 1. Consult a Rheumatologist & Neurologist – Since this symptom is new, it’s important to get a detailed neurological and musculoskeletal examination to determine if it’s nerve-related or due to arthritis progression. 2. Nerve Conduction Study (NCS) & Electromyography (EMG) – These tests will help check if the ulnar nerve is compressed or damaged. 3. X-ray or MRI (Hand/Wrist & Cervical Spine) – To assess joint damage, nerve compression, or other structural issues. 4. Physiotherapy & Hand Exercises – A physiotherapist can guide her with nerve gliding exercises and joint mobility exercises to prevent further stiffness. 5. Bracing or Splinting – If it’s a nerve compression issue, wearing a soft elbow brace at night (for cubital tunnel syndrome) or a wrist splint might help relieve symptoms. 6. Medication Review – If she is on long-term arthritis medications (NSAIDs, DMARDs, or steroids), a review of her treatment plan may be needed to adjust for any new complications. Since nerve-related issues can worsen over time, I strongly recommend seeing a neurologist or orthopedic specialist soon for a thorough evaluation. Early intervention can prevent permanent nerve damage and help improve function in her fingers.

Hi Syed Ibrahim Basha, I’m sorry to hear about your challenges after the ischemic stroke. You’ve shown great resilience by continuing your recovery, and I’ll try to guide you with some advice on managing your symptoms better. For Your Current Symptoms: 1. Right-Side Weakness (Leg and Hand): • Continue any physiotherapy you’re doing, as it is crucial for improving hand and leg function. Regular exercises targeting motor control, balance, and strength can help with mobility over time. • Occupational therapy may also improve fine motor skills (like finger movements). 2. Nausea and Eating Issues: • Since rice is causing discomfort, continue with light, digestible meals (e.g., idli, upma, or dalia). • Stay hydrated and have smaller, frequent meals. Ginger tea or antacid medications (like pantoprazole) may help if nausea is related to acidity. • Consult your doctor if nausea persists, as it may be a side effect of stroke medications. Treatment Suggestions: • Regular Follow-Ups: Keep up with your neurologist for any adjustments in medication (like anticoagulants or anti-platelet drugs). • Rehabilitation: Continue physiotherapy and explore hand exercises to improve wrist and finger function. • Blood Pressure & Sugar Control: Monitor these closely, as they’re critical for preventing further strokes. You’ve come a long way, and with continued effort, rehabilitation, and medical care, things can improve. Stay strong!