A female patient aged 32 presented with the complaints of severe pain in her right lower limb after a fall on her side of the body.
She complained of severe lancinating pain alone with bruised sensation with complete movement restrictions on her right lower limb.
Patient was unable to sit or move on her own she was bought for consultation by her husband. She was not able to walk without support.
On examinations –
- No swelling or discoloration of the skin
- Movement were restricted
- Tenderness on palpation over her right lower back
- “Fortin finger sign”- reproduction of pain after applying a deep palpation with the four-hand fingers posteriorly at the patient’s SI joint- Positive
- X- Ray – Normal, no anomalies were found.
Provisional diagnosis- Sacroiliitis
Acute Sacroiliitis -pain presentation varies greatly, and patients could describe pain in one or both buttocks, hip pain, thigh pain, or even pain more distal. Patients may report that their pain is worse after sitting for prolonged periods or with rotational movements.
Discussion
Acute Sacroiliitis is an inflammation of the sacroiliac joint (SI), usually resulting in pain. Often it is a diagnosis of exclusion. The sacroiliac joint (SI) is one of the largest joints in the body and is a common source of the buttock and lower back pain. It connects the bones of the ileum to the sacrum. Sacroiliitis can be particularly difficult to diagnose because its symptoms are similar to many other common sources of back pain. It often is overlooked as a source of back or buttock pain. Pain from this condition often is due to chronic degenerative causes yet relatively uncommon. Sacroiliitis can be secondary to rheumatic, infectious, drug-related, or oncologic sources. Some specific examples of non-degenerative conditions that can lead to sacroiliitis are ankylosing spondylitis, psoriatic arthropathy, Bechet disease, hyperparathyroidism, and various pyogenic sources.1,2,3
Symptoms considered for choosing right remedy
Aliments from fall
Lancinating pain developed after trauma
Bruised pain
Pain aggravated on least touch
Prescription
Arnica 1 M (3 doses) x 3days (H.S)
Follow up
Patient reported after 3days walking on her own with complete cure of her symptoms.
Patient said her pain was 50% better on d same day at the end of the 3rd dose of Arnica
Role of Arnica in treating traumatic cases-
It’s a traumatic remedy.
Trauma of all varieties it could be mental or physical, mechanical injuries, fall, bruises, contusions etc
Acts well on neuralgic or lancinating pains.
Extremities- Pain in back and limbs, as if bruised or beaten. Sprained and dislocated feeling < least touch, Aliments from trauma.4, 5, 6, 7
References
1. Slobodin G, Hussein H, Rosner I, Eshed I. Sacroiliitis – early diagnosis is key. J Inflamm Res. 2018;11:339-344. [PMC free article] [PubMed]
2. Chahal BS, Kwan ALC, Dhillon SS, Olubaniyi BO, Jhiangri GS, Neilson MM, Lambert RGW. Radiation Exposure to the Sacroiliac Joint From Low-Dose CT Compared With Radiography. AJR Am J Roentgenol. 2018 Nov;211(5):1058-1062. [PubMed]
3. Gutierrez M, Rodriguez S, Soto-Fajardo C, Santos-Moreno P, Sandoval H, Bertolazzi C, Pineda C. Ultrasound of sacroiliac joints in spondyloarthritis: a systematic review. Rheumatol Int. 2018 Oct;38(10):1791-1805. [PubMed]
4. Boericke W. Pocket Manual of Homoeopathic Materia Medica & Repertory: Comprising of the Characteristic and Guiding Symptoms of All Remedies (clinical and Pahtogenetic [sic]) Including Indian Drugs. B. Jain publishers; 2002.
5. Clarke JH. A dictionary of practical materia medica. InA dictionary of practical materia medica 1982 (pp. 2586-2586).
6. Phatak SR. Materia medica of homoeopathic medicines. B. Jain Publishers; 2002.
7. Nash EB. Leaders in homoeopathic therapeutics. Boericke & Tafel; 1901.
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