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60 YR OLD MALE WITH FEVER COUGH AND PAIN IN MULTIPLE SMALL JOINTS

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A 60 yr old male came to the OPD with chief complaints of  .Fever since 10days .pain in multiple joints of hand from past 2 yrs .pedal edema since 15 days HOPI:patient was apparently asymptomatic 2 yrs back then he had multiple joint pains( both hands metacarpophalangeal joints and both knee joints.joint restriction present . morning stiffness present c/o lower limb swelling since 1 yr pitting type till ankle H/o trauma to left leg middle toe 1 month back No c/o cough No c/o decreased urine output  H/o chronic NASID abuse since 1 yr for joint pain Past history:N/k/c/o HTN DM TB CVA CAD Asthma epilepsy  Family history:Not significant  Personal History   Diet:mixed   Appetite:decreased   Sleep:aquate   Bowel irregular and bladder: normal   No addictions     General Physical Examination   Patient is conscious coherent and cooperative     Moderately built and moderately nourished              No pallor,Icterus,cyanosis, clubbing,lymphadenopathy    Vitals          Temperature:100 F        
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60F Headache since 1month and fever with productive cough since 10 days

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MED CASE :-  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 patients' problems through a series of inputs from the available global online community of experts with an aim to solve those patients' clinical problems with collective current best evidence-based information. This E blog also reflects my patient-centered online learning portfolio and your valuable input in the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations, and coming up with diagnosis and treatment plans. is an online e-log book to discuss our patient's de-identified health data shared after taking his / her / guardians' signed informed consent. Here we
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A 45 year old male patient, shopkeeper by occupation presented with lower back pain and burning micturition.

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E LOG GENERAL MEDICINE  Hi, I am P Tejaswini , 3rd Sem Medical Student.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 inputs on the comment box is welcome.” I've been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan.  CHIEF COMPLAINT: Patient came with the complaints of lower back pain, burning micturition, dribbling of urin
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