PaJR Case Reports: 50M With Low Backache 4 years PIVD Nil FND WB PaJR

27-06-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTR TAKING HIS SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.

[27-06-2025 12.13] PPM 1: OPD now:

50M Long distance patient admitted under @PPM3 @PPM4 yesterday with low backache since 4 years.

Sudden onset after potato harvest lifting heavy weights 4 years back.

Intermittent claudication pain ever since then

Was operated for a left ureteric stone 7 years back and had a classic loin to groin pain at that time.

On examination:

SLR+- right lower limb

Trunkal muscle power less than 30%

No other focal neurological deficits

What would be the next intervention diagnostic and therapeutic for him @PPM5

@PPM3 please send for physiotherapy for back strengthening exercises and start Tab P650 and tablet Ultracet half 6 hourly for two days.

[30-06-2025 00:03] PA: Dui Din physiotherapy

Karate kamorer bethata kamache/tab ultracet haf four time/ tab pc650mg three time,

Kintu hatur nicher dike ektu ektu betha ache

[30-06-2025 07:24] PPM 1: Aajke teen jone ke niye OPD te dekha korben

[02-07-2025 14:31] PA: Totale 4 ta physiotherapy karar par kamorer bethata anekta kam? kintu hatur nich ta ajke bethata beshi hache sir

[02-07-2025 14:37] PPM 1: Dekha korun ICU te

[02-07-2025 14.57] PPM 1: @PP6 @PPM7 @PPM8 @PPM9 please send him to surgeons now for excision biopsy of this nodule

[02-07-2025 15:00] PPM 1: @PPM6 add tablet amitriptyline 10 mg one hour before dinner for four weeks.

The previous paracetamol and Tramadol is only for two days a week

[02-07-2025 15:00] PPM 7: Ok sir

[02-07-2025 15:04] PPM 1: @PPM6 please check his current grade of sacroileitis (part of his spondyloarthropathy) in his x-ray sacroiliac joints by getting it now again asap

I didn't realise earlier that the x-rays here 👇

https://pajrcasereporter.blogspot.com/2025/06/50m-with-low-backache-wb-pajr.html?m=1

Were done 3 years earlier!

[02-07-2025 15:04] PPM 6: Ok sir