Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Arthritis (Expert Forum)
Question about diagnosis
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
|
Question about diagnosis
by 1958, Dec 10, 2006 12:00AM
I am a 48 year old female. Two years ago I developed sciatica-like pain on the left. Straight leg raising test was always normal. MRI showed no disc or bony lesions but showed swelling of nerve roots. Multiple blood tests and LP were normal. Pain became more severe. On four occasions severe pain across top of thigh made walking impossible. Then began to develop pain in both arms and eventually left leg also. Further investigations. Only abnormality was bone scan showing "hot spots" in both shoulders, both hips and right knee.
Get occasional pins and needles in legs, feet and hands. Movement of joints is beginning to get painful, but no swelling or redness. (Have always had very good joint mobility and flexibility)
Have been diagnosed with Fibromyalgia. Am in almost constant pain, despite analgesics and antiflammatories. Major problem with sleep. Wake up in pain regularly. Have become increasingly disabled and now my career is in jeopardy.
The pains I have were always difficult to track when they started in each limb, but in the last 6 months it has become clear that they are following nerve root patterns in all limbs. My questions:
(a) is this type of pain typical of fibromyalgia?
(b) given the MRI finding of inflammed nerve roots without any obvious cause and the bone scan findings of "hot spots" should I accept the diagnosis of fibromyalgia or look for further investigations.
Any advice welcome as I am getting a bit desperate about the future.
Thank you
Get occasional pins and needles in legs, feet and hands. Movement of joints is beginning to get painful, but no swelling or redness. (Have always had very good joint mobility and flexibility)
Have been diagnosed with Fibromyalgia. Am in almost constant pain, despite analgesics and antiflammatories. Major problem with sleep. Wake up in pain regularly. Have become increasingly disabled and now my career is in jeopardy.
The pains I have were always difficult to track when they started in each limb, but in the last 6 months it has become clear that they are following nerve root patterns in all limbs. My questions:
(a) is this type of pain typical of fibromyalgia?
(b) given the MRI finding of inflammed nerve roots without any obvious cause and the bone scan findings of "hot spots" should I accept the diagnosis of fibromyalgia or look for further investigations.
Any advice welcome as I am getting a bit desperate about the future.
Thank you
Doctor's Answer
by Kevin Pho, MD, Dec 11, 2006 12:00AM
, Dec 11, 2006 12:00AM
To answer your questions:
1) Fibromyalgia can possibly explain the symptoms. Before attributing it to this disease, you may want to exclude other disorders - such as peripheral neuropathy and other neuropathic diseases. ANA levels and a rheumatoid factor can be drawn to exclude other rheumatologic disease.
2) Other than the aforementioned tests, you can consider electrodiagnostic testing, such as an EMG, to rule out neuropathy.
A referral to a neurologist or rheumatologist can be considered to further evaluate the symptoms.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
1) Fibromyalgia can possibly explain the symptoms. Before attributing it to this disease, you may want to exclude other disorders - such as peripheral neuropathy and other neuropathic diseases. ANA levels and a rheumatoid factor can be drawn to exclude other rheumatologic disease.
2) Other than the aforementioned tests, you can consider electrodiagnostic testing, such as an EMG, to rule out neuropathy.
A referral to a neurologist or rheumatologist can be considered to further evaluate the symptoms.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
Communities
Ask a Doctor Forums
Tools and Applications
Personal Information
Medical Information
Doctors and Partners