General medicine case discussion

A 58 year old male admitted with complainys of pain in the right lower limb since 2 months
HISTORY OF PRESENT ILLNESS:
Patient was apparently asymptomatic 2 months back then he developed pain in the right ankle which is insidious in onset, intermittent, dragging type, radiating to the right knee, aggrevated on walking and not relieved on medication
Patient also complained of pain in both wrist which is sudden, dragging type, non radiating, aggrevated on lifting heavy weights, associated with tightness, not relieved on medication and tingling sensation is present
Patient have headache occasionally in the frontotemporal region, associated with head heaviness, non radiating
No photophobia, phonophobia, nausea
No chest pain, SOB
No fever, cough
No h/o of burning micturation
PAST HISTORY:
H/O of trauma 2 months ago while chasing a Buffalo
H/O of polio in the childhood
N/K/O HTN, DM, Epilepsy, asthma
TREATMENT HISTORY:
Not significant
PERSONAL HISTORY:








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