tuberculosis arthritis
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Summary of Data Base
Mrs S/46 y o/W28Chief complaint: Right knee pain
Patient suffered from pain in the right knee since 1
year ago, especially when she walked and walked up
stair. It worsened since 2 months ago and makeslimitation of activity. It was accompanied with swelling on
the right knee, inflammed but no pain when pressed, leg
edema was negative.
History of trauma was denied. There were no
cracking sensation on morning stiffness. She didnt take
any analgetic.
She didnt complained about fever and cough.
Urination normal, defecation normal. Nausea, vomit, and
headache was denied.
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SUMMARY OF DATA BASE
History of past illness : 1 year ago she underwent joint fluid aspiration in RSSA
because of same complain
Hypertension since 15 years ago, no routine control, and
blood pressure is around 150/- History of DM was denied
History of social living : She had 3 children, worked as
factory labour. Her husband passed away 1 year ago
because renal failure, drunk traditional potion, analgeticand alcohol was denied
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Physical examinationWard BP: 170/100mmHg Ward PR: 90 bpm
regular strong
Ward RR: 20 tpm Ward Tax: 36,8C
General appearance looked ly moderately ill Ward GCS: 456 Looked overweight
BW: 70 BMI: 28.4
Head Within normal limit Within normal limit
Neck Within normal limit
Chest Heart: Ictus invisible and palpable at ICS V 2 cm lat MCL S
LHM ictus RHM: SL D
S1, S2 single, murmur ( - )
Lung: Within normal limit
Abdomen Within normal limit
Extremities Acral warm, leg edema -/-
Genu D swelling (+), pain (+), crepitation (-), mass (-)
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LAB VALUE (NORMAL) LAB VALUE (NORMAL)
Hb 12.2 11,0-16,5 g/dL Ureum 23.80 10-50 mg/dL
MCV 78.60 80-96 fl Creatinine 0.95 0,7-1,5 mg/dL
MCH 24.90 26,5-33,5 pg Kolesterol Total 111 50mg/dL
3.1 / 0.1 / 78.6/13.6 / 4.6 % Kolestrol LDL 98
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ECG
Sinus rhythm, heart rate 88 bpm Frontal Axis : N
Horizontal Axis : CWR
PR interval : 0,12
QRS complex : 0,08
QT interval : 0,36
Conclusion : Sinus rhythm HR 88 bpm
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Alignment: Good
Bone: fracture (-)
Joint: dislocation (-) Soft tissue: Looks swelling, radiolusent
appearence
Conclusion: Soft tissue swelling, gangrenegas
Genu R AP/Lateral
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CUE AND CLUE PL IDx PDx PTx PMo
Female / 46 yo
A
Genu D pain since 1
years ago
limitation of activityHistory sinovial fluid
aspiration
PE:
BW:76 BMI: 28.4
Swelling at genu D
Warm
pain (+)
Genu AP/Lat : Soft
tissue swelling
1. Chronic
monoarthrit
is genu
dextra
1.1 Tuberculosis
arthritis
1.2 Septic
arthritis
synovial
fluid culture
analysis ,
AFB
IV Plug
Inj. Ceftriaxon 2x1
PO: Parasetamol 3x500
mg
S, VS
Female / 46 yo
A
History of HT for 15
years
PE
BP 170/100
2.
Hypertensio
n st II
3.1 secondary
3.1.1
3.1.2
3.2
Funduscopy PO: captopril 3x25 mg S, VS
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CUE AND CLUE PL IDx PDx PTx PMo
Female / 46 yo
A
limitation of activity
History sinovial fluid
aspirationPE:
BW:76 BMI: 28.4
Swelling at genu D
Crepitation bilateral
genu (+)
3. OA genu
bilateral
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Tuberculosa arthritis Septic Arthritis
Hypertension
PROBLEM ANALYSIS
OA?
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Risk Factors
Artificial joint implants Existing joint problems(osteoarthritis, gout,
rheumatoid arthritis,or lupus)
Bacterial infection somewhere in your body
Cronic illness or disease (DM, RA, Sickle cell disease)
Intravenous or injection drug use
Medication that suppresed imune system
Recent joint injury
Recent joint arthroscopy or other surgery
Skin fragility
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Management analysis
Emergency: -
Urgency: -
Non Urgency:
Septic arthritisInj. Ceftriaxon 2x1
PO: Parasetamol 3x500 mg
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Condition this morning
BP: 160/100
PR: 88RR: 18
Tax: 36.8
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Thank you
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