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Suggest Treatment For Rheumatoid Arthritis

Posted on Wed, 28 Oct 2015

Question: MY MOTHER IS 45 YEARS OLD RA FACTOR IS POSTIVE, ESR 1HR READING IS 25MM, CRP POSITIVE, ALBUMIN TRACE. MICROSCOPIC : 6-10 PUSCELLS/hpf, 5-8 Epithelial cells/hpf
This is the report, can u advise what I need to next process.

Answered by Dr. Naval Mendiratta (3 hours later)

Brief Answer:
Rheumatoid Arthritis.

Detailed Answer:
Good evening

Well, I have gone through your reports.

Sorry, but the reports are not done in a proper method. Positive can be 11( when the range is from 1-10) or with 100. So we can never really be sure what exactly is positive. The same goes for Rheumatoid Factor.

If you could throw some light on the symptoms she has..Like joint pains/swellings/early morning stiffness that would be helpful

Await your reply

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naval Mendiratta (6 minutes later)

Thanks for ur reply.

Yes Doc.

She is having Knee joint pain, and swelling is there, from
last 3 years, but the severity is more now. Her weight is 85 kgs, height is 5.2,

Answered by Dr. Naval Mendiratta (9 hours later)

Brief Answer:
Osteoarthritis

Detailed Answer:
Good evening

Well, the knee joint pain alone does not point to rheumatoid arthritis. Considering her height and weight and with advancing age, it looks more where the cartilage is wearing off, a condition known as osteoarthritis of knees.

It is different from rheumatoid as you dont need too strong of a treatment for it and can be managed conservatively. But then again there is no definite treatment for it.

I would suggest you get an X ray of the knees done( standing) which will give us a fair clue on what is happening with the knees.

And if needed, we will repeat these tests from different labs once where they give accurate value

Please do let me know your location, so I can guide you to the right person

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naval Mendiratta (9 hours later)

Thanks for ur reply, I am residing in XXXXXXX
And any other further tests are required pls suggest.
And for relief from the pain we all already took anti biotics for
2 years, after that she faced side effects, that's why we stopped that
and now we are continuing Homeopathy treatment.

Answered by Dr. Naval Mendiratta (10 hours later)

Brief Answer:
Further Course

Detailed Answer:
good evening

Well, I would suggest you to get an X Ray done for the knees( Ap and Lateral View) in standing position.

I am not sure why they gave you antibiotics for the pain. It may have been different medication, but yes strong pain killers are to be avoided in this case.

As for the pain, plain crocin 650 mg is good. Also ask her to take calcium and vitamin D supplements along with Lubrijoint plus( 750 mg ) twice a day. Weight reduction and physiotheraphy would be helpful too

Do post the x ray film once you have got it done

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naval Mendiratta (24 hours later)

Thanks Doc,
I repeated all the tests again, and x-ray also,
Hence i saw the impression of Last stage of osteoarthritis in X-ray report
That's why i am worrying more, Considering her weight if we go for Surgery, what will be the side effects and we need to compulsory go through the surgey, pls prefer any specialists in XXXXXXX
And if the these tests are sufficient are not, any other tests required in detail.
Please suggest,
Currently i am residing in XXXXXXX
Attached reports are newly done today..... waiting for ur suggestion...

Answered by Dr. Naval Mendiratta (3 hours later)

Brief Answer:
Management of osteoarthritis

Detailed Answer:
Good evening

I have gone through her reports and they look ok. Except the X ray report

Well, Surgery is not an urgency for her at this stage. The decision of surgery is a call taken by the patient when they feel the quality of life is getting compromised. If she can carry on with her daily activities, we can defer it till we can.

But yes, losing weight and quadriceps exercises are a must . Just incase she needs surgery later on, her recovery can be better. 5 kg weight loss can help reduce the pain burden

Well, XXXXXXX has a lot of centers. I can give you my friends number there who is an Orthopaedic Working in Shri Ramachandra medical college. You can get in touch with him whenever needed.

Name : xxxxxxx
Phone number: 0000

Do let me know if any more help I can be

Regards
Dr Naval

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Above answer was peer-reviewed by : Dr. Neel Kudchadkar