A friend of mine in Chandigarh called me to fix an appointment for a 76 year old father (Mr X) of his friend in Delhi. Mr X was suffering from severe osteoarthritis of his both knees and had been advised knee replacement of both the knees by the two leading orthopaedic surgeons of Chandigarh region.
I was a bit reluctant to call the patient to my office as the diagnosis was already made and I had not much to contribute. But on my friends insistence and satisfaction, I agreed.
The 76 year old weak gracious gentleman walked limpishly with great difficulty into my office taking small steps a time and got seated in front of me. Initially, the thought baffled me that this 'old weak man with trembling hands' would be subjected to a major surgery but then i was relieved thinking that the operation would releive him of his troubles.
The main complaint of Mr X was that all his body was getting 'rigid' and he could barely walk, which was obvious. I started examining him (more so as a formality as he had come all the way to consult me). I requested him to slowly bend the left knee. To my surprise, he could bend 70% of the knee. On enquiring, he divulged that there was no pain in bending whatsoever. The same sequence was repeated on right knee with the same results. The findings puzzled me as the patient of severe osteoarthritis cannot easily bend his/her knees and that too without pain.
My mind started running in every direction and after few seconds, it struck " O my God, the patient has all the three components - Rigidity (he's complaining), Bradykinesia meaning decreased ability to walk and Tremor (I could see)- of Parkinson's disease".
I immediately rang Dr Manish Sinha, a neurologist friend in Alchemist Hospital, Panchkula and briefly told him the history, examination and the diagnosis. He exclaimed " Dr Pankaj, you have made the diagnosis, it must be correct. Pl send the patient to me tomorrow". I felt flattered by the compliment and more by the thought that the old man would be spared an unnecessary operation due to a wrong diagnosis.
Next day, the patient consulted Dr Sinha and his medications for Parkinson's disease were initiated.
I was a bit reluctant to call the patient to my office as the diagnosis was already made and I had not much to contribute. But on my friends insistence and satisfaction, I agreed.
The 76 year old weak gracious gentleman walked limpishly with great difficulty into my office taking small steps a time and got seated in front of me. Initially, the thought baffled me that this 'old weak man with trembling hands' would be subjected to a major surgery but then i was relieved thinking that the operation would releive him of his troubles.
The main complaint of Mr X was that all his body was getting 'rigid' and he could barely walk, which was obvious. I started examining him (more so as a formality as he had come all the way to consult me). I requested him to slowly bend the left knee. To my surprise, he could bend 70% of the knee. On enquiring, he divulged that there was no pain in bending whatsoever. The same sequence was repeated on right knee with the same results. The findings puzzled me as the patient of severe osteoarthritis cannot easily bend his/her knees and that too without pain.
My mind started running in every direction and after few seconds, it struck " O my God, the patient has all the three components - Rigidity (he's complaining), Bradykinesia meaning decreased ability to walk and Tremor (I could see)- of Parkinson's disease".
I immediately rang Dr Manish Sinha, a neurologist friend in Alchemist Hospital, Panchkula and briefly told him the history, examination and the diagnosis. He exclaimed " Dr Pankaj, you have made the diagnosis, it must be correct. Pl send the patient to me tomorrow". I felt flattered by the compliment and more by the thought that the old man would be spared an unnecessary operation due to a wrong diagnosis.
Next day, the patient consulted Dr Sinha and his medications for Parkinson's disease were initiated.
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