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Musculoskeletal Case Study | Week 10 Discussion NSG 5003, Latest Complete Solution.

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Musculoskeletal Case Study: A 30 year old Latino woman presents for evaluation of wrist pain and swelling. She developed symptoms about 3 months ago and has noted progressive worsening since that time. In addition, she ...

Musculoskeletal Case Study: A 30 year old Latino woman presents for evaluation of wrist pain and swelling. She developed symptoms about 3 months ago and has noted progressive worsening since that time. In addition, she has tenderness across the balls of her feet with any weight bearing. The pain is worse when she is inactive and improves with activity. The symptoms have significantly affected her ability to perform her job as a receptionist in a busy office. She denies any recent trauma to her hands or feet or other joint pain. She reports stiffness in the feet and ankles as well as 4 hours of overall morning stiffness that improves only marginally for the rest of the day. She has noted increased fatigue and weakness in activities significantly. She does not recall being bitten by any insects recently. PMH: Non-contributory SH: Receptionist, single, barely supports herself without assistance from close by family. Denies smoking history, social drinker on the weekends with friends. Medications: Birth control pills and MV ROS: Constitutional: Denies fever or chills, denies weight loss Eyes: Denies dry eyes or visual changes ENT: Denies dry mouth Respiratory: Denies difficulty breathing Cardiovascular: Denies chest pain Genitourinary: Denies bladder changes Gastrointestinal: Denies any bowel changes Endocrine: Denies polyuria, polydipsia, or polyphagia Musculoskeletal: Denies neck or shoulder stiffness Skin/Integument: Denies rashes, lesions, ulcers, changes in hair, skin or nails Physical Exam: General: Appears in no acute distress Vitals: 110 lbs, height 63 in., temp orally of 100 degree F, BP is 120/70. HR 64. RR 12 and regular. All other exam findings normal except: Neuromuscular: There is moderate synovitis (swelling) of the MCP and PIP joints bilaterally and of the MTP joints bilaterally. The patient has limited ROM of the UE and LE digits due to the pain. There are no nodules noted on any extremities. The Phalen’s, Finkelstein’s, and Tinel’s tests are negative. There is no warmth or redness of any joint. DTR’s are 2+ throughout.

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