67F came to OPD with pain in the Rt hand since 1yr and also with pain in the Rt and Lt knee joints.

She is a k/c/o Gastric ulcer since 20yrs.
She is suffering from Painful Rt upper limb which is of dragging type since 1yr , which aggrevates during sleep as she used to sleep on Right hand.
She Is even suffering from Rt and Lt knee joint pain since yrs , which is of pricking type.

K/c/o - hysterectomy
N/o - Bp, DM, thyroid , asthma, trauma, TB, CVA , CAD

Personal history:- 
Appetite:- normal , mixed diet , sleep :- disturbed, bowel and bladder movements - normal , no addictions

NO SIGNIFICANT FAMILY HISTORY

GENERAL EXAMINATION:- 
No pallor, no icterus, no clubbing , no cyanosis , no lymphadenopathy , no edema

RANGE OF MOVEMENTS:- shoulder - flexion, adduction, abduction, extension are normal; 
Neck movement:- normal (no stiffness) 

BP:- 120/80mm of Hg 
PR:- 80bpm
RR:-14rpm

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