A 60 year old female with joint pains
19th July 2023 CASE:- A 60 year old female, who was an agricultural labourer by occupation (but has stopped working since 4 years), came to the hospital with complaints of pain in both knees since 4-5 years, facial swelling since 2-3 months, pedal edema since 1 week. HISTORY OF PRESENTING ILLNESS:- The patient was apparently asymptomatic 4-5 years ago. She then started developing pain in both her knees which is aggravated on walking and standing, relieved on resting and medications (painkillers). She stopped working due to the pains. 2-3 months ago, she developed facial puffiness which was insidious in onset and gradually progressive in nature. It appears maximally in the mornings and gets relieved by the end of the day. 1 week ago, she had pedal edema upto her ankles which was pitting in nature. This also appears maximally in the morning and subsides by the end of the day. Her edema greatly subsided by itself after a week. She came to the hospital now to find a working solution for