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  • Case Presentation Power Point 13.06.2018 DR Abhinav JR III

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    A 13-year-old male presented with pain and swelling in both knees, left foot, left leg, and back for 14 days. He also had fever for 14 days and redness of both eyes for 14 days. Based on the history of presenting illness and examination, differential diagnoses considered included systemic onset juvenile rheumatoid arthritis, reactive arthritis, tubercular arthritis, psoriatic arthritis, and systemic lupus erythematosus. Laboratory investigations were done and the final diagnosis was systemic onset juvenile rheumatoid arthritis based on the polyarthritis for more than 6 weeks, fever, cardiac involvement, and history of eye inflammation.

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    Case Presentation Power Point 13.06.2018 Dr Abhinav JR III

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    A 13-year-old male presented with pain and swelling in both knees, left foot, left leg, and back for 14 days. He also had fever for 14 days and redness of both eyes for 14 days. Based on the history of presenting illness and examination, differential diagnoses considered included systemic onset juvenile rheumatoid arthritis, reactive arthritis, tubercular arthritis, psoriatic arthritis, and systemic lupus erythematosus. Laboratory investigations were done and the final diagnosis was systemic onset juvenile rheumatoid arthritis based on the polyarthritis for more than 6 weeks, fever, cardiac involvement, and history of eye inflammation.

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    45 views11 pages

    Case Presentation Power Point 13.06.2018 DR Abhinav JR III

    Uploaded by

    sumit
    A 13-year-old male presented with pain and swelling in both knees, left foot, left leg, and back for 14 days. He also had fever for 14 days and redness of both eyes for 14 days. Based on the history of presenting illness and examination, differential diagnoses considered included systemic onset juvenile rheumatoid arthritis, reactive arthritis, tubercular arthritis, psoriatic arthritis, and systemic lupus erythematosus. Laboratory investigations were done and the final diagnosis was systemic onset juvenile rheumatoid arthritis based on the polyarthritis for more than 6 weeks, fever, cardiac involvement, and history of eye inflammation.

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    © All Rights Reserved
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    CASE PRESENTATION

    Date of Presentation 13.06.2018

    PRESENTER –DR ABHINAV PAWAR


    MODERATOR- Dr. SHRISH
    BHATNAGAR (MD)
    PATIENT IDENTIFICATION DETAILS

    • Patient Shisu verma age 13yrs sex male


    • s/o-
    • R/O –
    • Hindu by religion
    • Verma by caste
    • Born by non-consanguineous marriage
    • Informant - mother
    CHIEF COMPLAINTS

    • Pain and swelling in both knees left foot left


    leg and back x 14days
    • Fever x 14days
    • Redness of both eyes x 14days
    HISTORY OF PRESENTING ILLNESS
    • As stated by patients mother pt. was apparently
    asymptomatic 14days back when he developed pain
    and swelling initially in back and left foot which was
    progressive and associated with limitation of movement
    and morning stiffness. Pain was sever in intensity, non
    radiating, aggravated on movement and relieved on
    taking medication. Pain after 3days progressed to left
    hand and subsequently after 3days involved both the
    limbs. Movement at knee joint was associated with
    crackling sound.
    HISTORY OF PRESENTING ILLNESS
    • Fever for 14days which was acute, high grade,
    undocumented, not associated with chills and
    rigor, no diurnal variation.
    • Redness of both eyes since 14days which was
    relieved after taking medication in the form of
    eye drops .
    NEGATIVE HISTORY
    • No H /o burning micturition
    • No h/o cough
    • No h/o sore throat
    • No h/o rash
    • No h/o bone pain
    • No h/o palpitation
    • No h/o breathlessness
    • No h/o headache
    • No h/o bleeding from any site,
    • No h/o pain abdomen,
    • No h/o wt. loss
    PAST HISTORY

    • h/o loose stools present 20 days back which


    was acute, 6 to 8 times per day, semi solid,
    associated with blood and mucus, non foul
    smelling.
    • h/o pain at right side of back 8 yrs. back
    • h/o pain and swelling in left knee, associated
    with limitation of movement 1 yr. back
    • No h/o tb contact
    • No h/o psoriasis in any family member.
    SOCIOECONOMIC HISTORY

    • Education of the head of the family – illiterate


    • Total no. of members in family - 13
    • Occupation – farmer
    • Monthly income – Rs
    • Per capita income – Rs
    • Patients belongs to upper lower class
    DIFFERENTIAL DIAGNOSIS

    • Systemic onset Juvenile Rheumatoid Arthritis


    • Reactive Arthritis
    • Tubercular Arthritis
    • Psoriatic Arthritis
    • Systemic Lupus Erythematosus
    • Inflammatory Bowel Disease
    INVESTIGATIONS

    Complete blood count


    ESR
    CRP
    Rhematoid Factor
    Antinuclear Antibody (ANA)
    FINAL DIAGNOSIS

    Systemic Onset Juvenile Rheumatoid Arthritis


    • Polyarthritis
    • Duration of more than 6 weeks
    • Fever
    • Cardiac involvement
    • H/O eye inflammation

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