Dr. Mukesh Bhalla (pt) (Physiotherapy) needs a second opinion on this medical case.
A 78 y/o female complains of pain in b/l hips, knees, and hands for 3 years. She complains of difficulty in walking and getting up from sitting along with low back pain. Today she could not get up from the floor.
No history of arthritis or osteoporosis.
Past medical & surgical history non-contributory.
BP: 140/80 mmhg, Pulse: 75 bpm, Resp rate: 17 bpm, Temp: 98.5 degree F
No numbness or swelling on joints.
Neurological examinations normal.
Gait slow & stiff.
Decreased range of motion in hands.
Decreased flexion and extension in back.
Hips have decreased ROM with internal/external rotation.
Knees enlarged with decreased flexion/extension and crepitation present bilaterally; right greater than left.
What is the diagnosis?
How should the patient be managed?