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Differential Diagnosis
The patient has presented with various symptoms and sign that prompt the need for a unique and proper differential diagnosis. The differential diagnosis is meant to enhance the better treatment and management strategies after identification of the main disorder. A differential diagnosis of endometriosis disorder which is also associated with musculoskeletal pain would be carried on the patient (Nelson et al, 2012).
The symptoms for endometriosis include heavy bleeding and irregular periods, dyspareunia problems, painful urination. E.g. during menstruation and pelvic pain especially in the lower abdomen. Some of the differential diagnosis include tests for generalized pelvic pain, pelvic adhesions and levators spasm. caused by musculoskeletal causes and also primary and secondary dysmenorrhea. Dyspareunia evaluation would be carried by assessment of pelvic vascular congestion. The patients only had irregular periods and dyspareunia problems as the main symptoms reported.
Primary Diagnosis
The primary diagnosis for primary and secondary dysmenorrhea caused by musculoskeletal pain is essential for the patient which is carried out through physical examination (Nelson et al, 2012). Primary phases is due to pain causes while secondary is due to organic diseases. Biochemical tests can also be used during clinical assessment. The patient reports pain in various parts of the body which necessitates the tests such as DNA probe testing and abdominal ultrasonography (Nelson et al, 2012).
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Treatment and Management
Medical treatment for endometriosis includes the use of medication such as danazol to relieve symptoms of the disorder. Use of agents such as goserelin and leuprolide is vital medication for relieving pain. Treatment for the musculoskeletal pain includes taking dosages like norepinephrine, serotonin, eszopiclone and ramelteon. Surgical treatment is recommended for the advances in endometriosis disorder (Apte et al, 2012).
Other pharmacological treatment measures include taking vaginal estrogens, local anesthetics, corticosteroids as management for dyspareunia. Clinical guidelines such as the emphasis on exercises, therapeutic massage, and osteopathic manipulations are essential for management of her condition (Lier et al, 2016).
Education would be provided to the patient regarding the importance of following the right prescription provided. Education on the necessity for modification of sexual positions during intercourse and offering psychological treatments would be vital in treatment and management of the condition suffered by the patient (Nelson et al, 2012).
The multidisciplinary approach would be adopted by incorporating effective pain management sessions for the patient, clinical psychology, physiotherapy as well as psychosocial drugs (Lier et al, 2016). The adoption of these strategies is effective in the management of the medical problems facing the patient.
References
Apte, G., Nelson, P., Brismée, J., Dedrick, G., Justiz, R., & Sizer, P. S. (2012). Chronic Female Pelvic Pain-Part 1: Clinical Pathoanatomy and Examination of the Pelvic Region. Pain Practice, 12(2), 88-110. doi:10.1111/j.1533-2500.2011.00465.x
Lier, R., Mork, P. J., Holtermann, A., & Nilsen, T. L. (2016). Familial Risk of Chronic Musculoskeletal Pain and the Importance of Physical Activity and Body Mass Index: Prospective Data from the HUNT Study, Norway. Plos ONE, 11(4), 1-13. doi:10.1371/journal.pone.0153828
Nelson, P., Apte, G., Justiz, R., Brismeé, J., Dedrick, G., & Sizer, P. S. (2012). Chronic Female Pelvic Pain-Part 2: Differential Diagnosis and Management. Pain Practice, 12(2), 111-141. doi:10.1111/j.1533-2500.2011.00492.x
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