34-year-old male patient presented in the clinic. He had complaints of severe multiple small joint pain ( in wrist, finger, toes, Etc.). He also had complaints of swelling in joint and morning stiffness in his hands. Associated with weight loss and fatigue. he found some nodules in the body.
On examination wrist, ankles, (proximal joint) PIP, MCP, MTP were symmetrically involved. joint tenderness was present. Ulnar deviation at the metacarpophalangeal joint. Rheumatoid nodules were present. Had muscle wasting. All suggestive of Rheumatoid Arthritis (RA).
Rheumatoid (RA)factor and Antibodies to cyclic citrullinated peptide (ANTI-CCP) were present. Anemia of chronic disease present.
So diagnosis of Rheumatoid Arthritis (RA) was confirmed.
Rheumatoid Arthritis (RA) Treatment
started on Methotrexate (weekly once only). prednisolone (low dose for short term), Hydroxychloroquine and folic acid. Treatment with NSAID and PPI for symptomatic use.
Patient was better on next day. he able to perform all routine activities without pain. Doing well.
DR RAKESH UKEY MD
Ulnar deviation at the metacarpophalangeal joint and Rheumatoid nodule in RA
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