Dr. Mukesh Bhalla (pt) (Physiotherapy) needs a second opinion on this medical case.
*Chief Complaint* 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. *History* No history of arthritis or osteoporosis. Past medical & surgical history non-contributory. *Vitals* BP: 140/80 mmhg, Pulse: 75 bpm, Resp rate: 17 bpm, Temp: 98.5 degree F *Investigations* 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. *Diagnosis* What is the diagnosis? *Treatment* How should the patient be managed?
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