Abstract
A 45 year-old woman with rheumatoid arthritis (RA) showed symptoms at the age of 41.She was treated with disease modifying antirheumatic drugs (DMARDs). Blood examination data showed gradual improvement, but the patient’s knee joint destruction developed. The attending doctor (physician) said “You need a total knee arthroplasty (TKA) operation”. The patient said “I’ve always complained of knee joint pain, but the doctor didn’t conduct X-ray examination. I can’t consent any more”. The attending doctor had not recorded knee joint pain. Then, she changed hospitals, and consulted our hospital. Her knee joints were destructed (Stage 4). We tried hyaluronic acid injection in knee joints, but her knee joint pain did not improve. Finally, we enforced TKA. She, and her family demanded clinical record be presented to the previous hospital. However, even if her previous doctor did make joint injections, knee joint destruction was not prevented. Although RA therapy is advanced, it is not perfect. If the patient experienced any falls, the previous doctor did not record the details in medical reports. In the future, there is a possibility that lawyers could file a medical lawsuit. This report suggests, that recording detailed medical reports (complaints, physical examinations, operations and so on) as soon as possible is important.
