50yr Female with complaint of backache,knee pain , legpain since one month.
History of presenting illness: The patient was apperently asymptomatic one month ago and then developed back ache and knee pain. Due to which the patient experienced disturbed sleep leading to head ache. The pain was incidious in onset and gradually progressive . The aggravating factors are sleeping on floor early mornings and disturbed sleep. Relieving factors are taking rest and massage . The pain is radiating and dragging type . It is associated with dizziness , neck stiffness and weakness. Past history: There is a history of an episode of seizures 30 years back and is still on medication. The patient is a known hypotensive. Personal history: Sleep - adequate Appetite- reduced Diet - mixed Bowel and bladder movements regular Addiction-no addictions Allergies- no known allergies There was darkening of skin and scaly lesions on both feet of the patient since 26 years . The patient is not on any medication . Family history: Darkening of skin and scaly lesions in the family is posit