case presentation on OA

1. Case Presentation on
Osteoarthiritis
---Presented By:
Shruti Singh

2. Personal data
Name of Patient : Mrs. ABC
Age : 45 years
Sex: female
Marital status: married
Occupation : housewife
Address : Jobner

3. Presenting complaints
Pain in knee joint for last 3 years
Location : both knee joint; more
on medial side.
Sensation : tearing pain, stiffness
Modalities : < walking, movement, cold &
cloudy weather.
> massage , warm application.

4. Associated complaints
--- difficulty in walking due to her
complaints.
< walking after sitting for a long
duration.

5. History of present illness
Patient was well before 3 years. Firstly there
was mild pain which was relieved by taking
painkillers. Gradually the pain increased in
intensity and there started to remain swelling
on both knees which restricted her household
activities. She is taking physiotherapy for her
complaints. As the pain was unbearable she
approached to homoeopathy.

6. Past history
Hypothyroidism – 15 years of age-
allopathic treatment – relief.
Jaundice – 4 years ago – allopathic
treatment – Recovery.

7. Family history
Father Alive Joint pain
Mother Alive Cataract
Brother Alive Healthy
Sister Alive Healthy
Grandfather Dead ----------
Grandmother Dead ----------
Children (2) Alive Healthy

8. Gynaecological history
Age of menarche: 13 years
Details of menstruation:
- regular , 30 days cycle for 5 days.
- profuse, clotted, black, non
offensive and bland.

9. Climacteric history
Age of menopause: 42 years
Complaints associated:
---She complained of burning in soles
during menopause.

10. Obstetrics history
 G2 P2 A0 S0 L2
DEAILS OF DELIVERY:
NO. COMPLAINTS
DURING
PREGNANCY
TYPE OF
DELIVERY
BABY WT ALIVE OR
DEAD
LACTATION
HISTORY
1. NO
COMPLAINTS
FTND 3 Kgs ALIVE FOR 6
MONTHS
2. NO
COMPLAINTS
FTND 2.75 Kgs ALIVE FOR 6
MONTHS

11. PHYSICAL GENERALS
 Constitution - fatty, dark complexion, dark hairs
 Appetite - 2 chapatis at meal ; twice daily .
 Thirst -4- 5 glasses of water in day ; no desire to drink
at night; prefers normal water.
 Desire – not specific
 Aversion- sour things
 Stool – regular; once daily; no straining; soft stool.
 Urine – 3- 4 times in daytime ; 2 times at night; pale
yellow; no burning ;non offensive.

12.  Sweat – mild and generalized; non offensive.
 Sleep – sleeps at 10 pm and wakes up at 5 am; lies
straight on back; unrefreshed.
 Dreams – nothing specific
 Thermals – Hot patient.

13. Mental generals
 Patient is very calm and having polite nature.
 She is very much worried about her complaints .
 She wants to get well soon but as there was no relief
after taking initial treatment she has no hope for her
recovery.
 She dislike arguments and avoids disputes; wants
everyone in the family have good relations with each
other.
 She like to remain silent and is less talkative.
 Memory is good .

14. General examination:
 Conscious/ unonscious : conscious
 Height : 5.1 “
 Weight : 78 kgs
 Anemia : not present
 Cyanosis : not present
 Jaundice : not present
 Nails: clean
 Gait : walking with support of wall with short steps and
slowly
 Lymphadenopathy : not palpaple
 Blood pressure: 140/90 mm Hg
 Pulse : 76 beats/ min
 Temperature: 99 degree F
 Respiratory rate: 20/ min

15. Systemic examination:
 Respiratory system: no abnormality found
 Cardio- vascular system: S1 and S2 audible.
 Nervous system: no abnormality found
 Gastrointestinal system: no abnormality found.
 Locomotor system:
- bilateral swelling on medial side of knee joint.
- no redness
- affected part was cold on palpation.
- cracking sound on knee extension

16. Laboratory investigations
1. CBC
2. ESR
3. X- ray – knee joint---- AP view, Lateral view.
4. Serum calcium
5. Serum uric acid .

18. Differential diagnosis:
1. Osteoporosis
2. Osteoarthritis
3. Rheumatoid Arthritis
4. Gouty arthritis

19. Provisional diagnosis
 OSTEOARTHRITIS

20. ANALYSIS OF SYMPTOMS
MENTAL GENERALS:
 Patient is very calm and having polite nature.
 She is very much worried about her complaints .
 She wants to get well soon but as there was no
relief after taking initial treatment she has no
hope for her recovery.
 She dislike arguments and avoids disputes; wants
everyone in the family have good relations with
each other.
 She like to remain silent and is less talkative.
 Memory is good .

21. PHYSICAL GENERALS
 Thirst -4- 5 glasses of water in day ; no desire
to drink at night; prefers normal water.
 Aversion- sour things
 Sleep – sleeps at 10 pm and wakes up at 5 am;
lies straight on back; unrefreshed.
 Thermals – Hot patient.

22. PARTICULARS
 Pain in knee joint for last 3 years
Location : both knee joint; more
on medial side.
Sensation : tearing pain, stiffness
Modalities : < walking, movement, cold &cloudy
weather.
> massage , warm application
 difficulty in walking due to her complaints.
< walking after sitting for a long duration.

23. Evaluation of symptoms
 Patient is very calm and having polite nature.
 She is very much worried about her complaints .
 She wants to get well soon but as there was no relief after
taking initial treatment she has no hope for her recovery.
 She dislike arguments and avoids disputes; wants everyone in
the family have good relations with each other.
 She like to remain silent and is less talkative.
 Memory is good .
 Thirst -4- 5 glasses of water in day ; no desire to drink at night;
prefers normal water.

24.  Aversion- sour things
 Sleep – sleeps at 10 pm and wakes up at 5 am; lies straight
on back; unrefreshed.
 Thermals – Hot patient.
 Pain in knee joint for last 3 years
Location : both knee joint; more
on medial side.
Sensation : tearing pain, stiffness
Modalities : < walking, movement, cold &cloudy weather.
> massage , warm application
 difficulty in walking due to her complaints.
< walking after sitting for a long duration.

25. Totality of symptoms
 Patient is very calm and having polite nature.
 She like to remain silent and is less talkative.
 She is very much worried about her complaints .
 She wants to get well soon but as there was no relief
after taking initial treatment she has no hope for her
recovery.
 She dislike arguments and avoids disputes; wants
everyone in the family have good relations with each
other.

26.  Thirst -4- 5 glasses of water in day ; no desire to drink at
night; prefers normal water.
 Aversion- sour things
 Sleep – sleeps at 10 pm and wakes up at 5 am; lies straight
on back; unrefreshed.
 Thermals – Hot patient.
 Pain in knee joint for last 3 years
both knee joint; more on medial side.
Sensation : tearing pain, stiffness
Modalities : < walking, movement, cold & cloudy weather.
> massage , warm application
 difficulty in walking due to her complaints.
< walking after sitting for a long duration.

27.  SELECTION OF REMEDY:
Rhus toxicodendron
 SELECTION OF POTENCY: 200 1 DOSE
 PRESCRIPTION:
Rx
Rhus tox. 200/stat

28. GENERAL MANAGEMENT :
1. AVOID WEIGHT LIFTING.
2. PERFORM MILD EXERCISE ADVISED
BY THE PHYSIOTHERAPIST.
3. AVOID SOUR THINGS.
4. DRINK MILK TWICE A DAY.