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46-year-old male of African descent, December 1, 2009 admission.
Chief Complaint: limbs, with decreased muscle strength, muscle atrophy 2 months.
History of present


illness: body and health of patients in the past, from October 2009 onwards, on the right lower extremity muscle strength was decreased to a local community hospital emergency department treatment and was told to have cerebrovascular accident, were discharged after treatment, but the symptoms did not improve . Patients and the gradual emergence of the left upper and lower extremities weakness, but the right is more serious than the left, and the emergence of muscle atrophy. The right hand can not flexor, wrist can bend, the left hand, wrist flexor strength also decreased. Also significantly decreased muscle strength of lower limbs (r left), can not stand up, in serious difficulties. Meanwhile, patients have also had fatigue, mouth and eyes dry, after the event shortness of breath, joint pain, swelling, muscle pain, morning stiffness and intermittent headaches. Patients denied butterfly erythema, discoid erythema, rash, erythema nodosum, arthritis significantly, oral ulcers, hair loss or obvious bentonite, light sensitivity, seizures, hematuria, proteinuria, pericardial or pleural effusion, skin vasculitis , scleritis / episcleritis, chronic sinusitis, epistaxis, hemoptysis, intractable abdominal pain, testicular pain, Raynaud's phenomenon, scleroderma.Personal history: None addicted to alcohol and tobaccoPhysical examination: proximal lower limb flexor muscle I / V; distal lower limb muscle strength of II / V, the proximal upper limbs muscle strength of IV / V, the right wrist flexor muscle I / V, extensor muscle strength II / V ; left wrist flexor muscle II / V, extensor muscle strength III / V; right hand finger flexor muscle I / V, extensor muscle strength II / V; left fingers flexor muscle II / V, extensor muscle strength III / V; no bilateral deep tendon reflexes; no bilateral pathologic reflex; the rest were normalWBC 12k/ul (N61%, L29%, 4-10); Hb 12g/dl (12.8-17); Plt 291k/ul (106-410); Cr 0.77mg/dl (0.64-1.27); BUN 11mg / dl (8-20); AST 19U / L (12-50); AST 51U / L (17-63)
ESR 20mm / h; CRP 2.7U / L (<10); CPK 463 (55-170)
Urine (-)
Chest plain film X ray: bilateral hilar lymphadenopathy, no abnormal rest1) The impression of diagnosis;
One judge has been resolved rheumatoid arthritis blood test What reward points: 0 -
Patients reported Gender: Female age: 53 healthy life is everyone's yearning for why the time is short
Rheumatoid factor response albumen 10.4 0-14C 1.4 43.7 0-5 antistreptolysin 0-200; white of an egg-negative anti-keratin anti-cyclic citrullinated peptide antibody-negative 53-year-old leg pain for several years, the pain got worse recently, upstairs legs pain, painful joints feeling sleep eating spur film, the effect is not obvious that these are my blood test declaration Thank you! To help people solve their problems do not understand the dietary supplement health problems not
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Hello, analysis of test results normal, do not support the diagnosis of rheumatoid joints, leg pain, osteoarthritis may be that the knee joint degeneration, and aches and pains may be as many fibromyalgia syndrome or rheumatic muscle pain. To deal with the evaluation of the answer the questioner: health is everyone's longing for life, health is everyone's yearning for life
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