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1. W e l c o m e t o c a s e p r e s e n t a t i o n . Dr. Md . Deen Islam MS Resident (Phase-B) B l u e - 1

2. P articulars of the patient Name : Mrs. Taslima Akter Age : 40 years Address : Mohammodpur, Dhaka Ward : NB Bed : 954 Date of admission : 05 .0 6 .22

3. P r e s e n t i n g C o m p l a i n t s : • Pain in left Knee for 10 years. • Difficulty in walking and squatting for same duration.

4. HISTORY OF PRESENT ILLNESS According to the statement of the patient, she was reasonably well 10 years back. Then she experienced pain in left knee,initially which was mild,intermittent, localized and non radiating. But the intensity of pain was incresing gradually and at present she is unable to do day to day activities due to pain. She also complains difficulty in walking and squatting for same duration. she is a known case of Rheumatoid arthritis.

5. History of past illness : She is a diagnosed case of Rhematoid Arthritis. Drug history : H/O taking Oral steroid and Methotrexate. Family History : None of her family members are suffering from such type of illness.

6. G e n e r a l E x a m i n a t i o n : All vital parameter are within normal physiological limit. S y s t e m i c E x a m i n a t i o n : Reveals no abnormalities.

7. L o c o - r e g i o n a l E x a m i n a t i o n L o o k : • D e f o r m i t y : G e n u v a l g u s a n d F l e x i o n d e f o r m i t y • S w e l l i n g : p r e s e n t • M u s c l e w a s t i n g : a b s e n t • a p p a r e n t L L D : a b o u t 3 c m • Gait : Antalgic. • Squatting : Not possible.

8. • Temperature : n ormal • Tenderness : absent • Muscle wasting : absent. • LLD : 1 cm • FFD : 30 degree • F urther ROM : 50 degree • P a t e l l a r T a p t e s t : p o s i t i v e • Q a n g l e : a b o u t 1 5 d e g r e e F e e l

9. • P l u m b l i n e t e s t : m e d i a l m a l l e o l u s l i e s l a t e r a l t o l i n e • K n e e f l e x i o n t e s t : p o s i t i v e • Varus and valgus stress test: Negative • D N V S : i n t a c t

10. M o v e : ROM of Rt Knee : O-150 degree ROM of Left Knee : 30-50 degree Spine,Hip and Ankle movement within normal limit.

11. Radiology

12. D i a g n o s i s : Genu Valgus deformity due to Rheumatoid Arthritis. U n i t P l a n : Total Knee Replacement.