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Dr. vishal-kaura

Dr. Vishal Kaura Aggarwal
Visiting Consultant
Department of Advanced
Interventional Rheumatology
BLK Super Speciality
Hospital, New Delhi











Dealing with Rheumatoid Arthritis

Early diagnosis and treatment – the cost-effective
way to improve quality of life

THE CASE

A 60-year old female patient visited BLK for OPD consultation with complaints of pain and swelling in knees and few other joints with excessive fatigue for about a year-and-a-half. She had made multiple rounds of visits to a renowned Orthopaedician for knee surgery to get rid of the pain and poor quality of life that she was living with.

The Orthopaedician at BLK suspected her to have Rheumatoid Arthritis and suggested review for surgery after 2 to 3 months. In the interim she was referred to Dr. Vishal Aggarwal for further treatment plan. Dr. Aggarwal assessed the patient thoroughly and diagnosed her to have Seropositive Rheumatoid Arthritis with 5 tender and 3 swollen joints in moderate disease activity. The knees had synovitis with moderate effusion along with some osteoarthritic changes and decreased range of movements.

THE TREATMENT

Dr. Vishal took stock of the patient’s condition and started her on disease modifying drugs ( DMARDs). Her knees were aspirated which yielded infl ammatory synovial fl uid. It was followed by intra-articular injection- Triamcinolone in both the knees. She was advised rest for a day, to be followed by various recommended exercises.

THE RESULT

The patient came back after a month-and-a-half walking all by herself. She was 70% better with no tender joints. Her knees now had minimal swelling and crepitus with full range of movements.

DISCUSSION

Rheumatoid Arthritis causes damage to the cartilage and bones of the affected joints. This results in early Osteoarthritis at a young age leading to deformity and disability requiring surgery. If Rheumatoid Arthritis is recognised and diagnosed early, especially in the first 6 months and managed optimally, there is no need for a major surgical intervention.