[29F] With chronic joint pain, fatigue, and polydipsia

Patient Description

A 29-year-old female presents with chronic joint pain described as a full ache with sharp pains upon movement, affecting the wrists, hips, knees, jaw, and shoulder, leading to difficulty in ambulation and discomfort while sitting, standing, and lying down. The pain is rated 6/10 at rest and 8/10 with activity, worsening in the mornings and evenings. The patient has been experiencing these symptoms for over a year, with no relief from ibuprofen. A cane is used for balance. Additionally, the patient reports chronic fatigue, a loss of appetite for about 2 years, and difficulty finishing meals. Sleep disturbances include trouble falling asleep and feeling unrested after 4 hours of sleep. The patient also experiences dry mouth with constant thirst and frequent urination every hour for the past 3 years. There is a history of diabetes diagnosed 3 years ago, and the patient is currently being tested for autoimmune diseases. Known allergies include augmentin, penicillin, soy, and tree nuts. Current medications include Methotrexate, Folic Acid, Trulicity, Crestor, Adderall, Lamotrigine, Seroquel, Prazosin, and Testosterone.

Arora's Assessment

What might be happening

Based on the information provided, possible diagnoses include:

Systemic Lupus Erythematosus (SLE): This is an autoimmune disease that can affect many different body systems, including the joints, skin, kidneys, blood cells, brain, heart, and lungs. Symptoms can include fatigue, joint pain, rash, and fever. ANA positive is a common finding in SLE.
- Treatment usually involves drugs to suppress the immune system, like corticosteroids or immunosuppressants.
Rheumatoid Arthritis (RA): This is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints, and can also cause fatigue.
- Treatment typically involves medications to reduce inflammation in order to prevent joint damage.
Sjögren's Syndrome: This is an autoimmune disease characterized by dryness of the mouth and eyes, fatigue, and joint pain. It can also cause dysfunction of other organs such as the kidneys, gastrointestinal system, blood vessels, lungs, liver, pancreas, and the central nervous system.
- Treatment typically involves managing the symptoms, such as using artificial tears and drinking plenty of water to alleviate dryness.

Please note that these are just possibilities and not a definitive diagnosis. You should consult with a healthcare professional for an accurate diagnosis.

What you can do

Continue to take your prescribed medications as directed by your doctor.
Maintain a balanced diet and stay hydrated. This can help manage your symptoms and support your overall health.
Try to engage in light physical activities, such as walking or stretching, to help alleviate joint pain.
Keep a symptom diary. This can help you and your healthcare provider identify triggers or patterns in your symptoms, which can be useful for managing your condition.