Learnings from Tele Medicine
A few patients that a physician came across in this “lockdown season” over Tele links, and the experiences are being shared for reflections. Late 30s lady, presented from a remote South Asia country location with a swelling in the right thumb, over the MPJ. Pain and swelling have been there for about 4 to 6 weeks, with worsening pain and swelling over the preceding week. Since there was no health care professional locally who could examine, all the consultation was over WhatsApp video calls. The joint appeared swollen and red, with self-elicited severe tenderness. Patient was initiated on Amoxycillin with Clavulanic acid, and NSAIDS. A complete blood done showed High Leucocyte count with predominant polymorphs and a high ESR. Antibiotics were continued, but soon there was an abscess that formed at the site that burst and a non-healing ulcer and sinus was seen. ESR continued to be high and 8 weeks into the illness, an X-ray done showed an osteomyelitis of the metacarpal bone with dam