A 57 years old woman, known diabetic dyslipidemic, gout, hypothyroidism under treatment presented with acute pain in great toes,foot,ankle and legs up to knee of both limbs followed by muscle pain and fever.Investigation:- Cbc, kft, calcium, electrolyte, Vitamin D , Vitamin B12, CRP normal. Significant reports:- ESR 60, uric acid 6.5, Hba1c 6.0, Fbs 170, liver profile normal except sgpt, alkaline phosphatase slightly raised, Thyroid profile normal except TSH of 3 rd generation6.027, lipid profile TC 233, ldl 194, HDL 25, Tgs ,746. Serum iron profile normal except ferritin 440.
What is the diagnosis? How to manage this case? Please share.
