Unresolved pain in a middle-aged woman: an integrated family medicine approach

Abstract

47 years old woman had applied to the outpatient clinic as she was suspicious because of COVID-19. The patient has non-specific symptoms such as fever, pain, and anosmia. The family physician has prescribed Enfluvir, vitamin D, etol-fort tb . After the medication, she has come to the clinic again because of the not finished pain. The family physician that the first one consulted has ordered Magnetic Resonance Imagining for the sacroiliac region as the patient told that the pain when she was sitting for at least two and half years and nowadays her pain was more although she was taking her painkillers. According to the non-contrast, MRI of the sacroiliac joint: “ joint surfaces exhibit irregularity and narrowing. In the posterior, more prominent articular surfaces on the right in the fat-suppressed axial and coronary sequences, there is focal bone marrow edema and sacroiliitis activation. The right adnexa within the sections showed an 8 cm cystic appearance. MRI and USG of the lower abdomen are advised.”. The lab and also with IV contrast, MRI of the pelvis, and ultrasonography were planned with the rheumatology and gynecology consultations.