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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: High white blood count in extracted fluid....Forum: Neurology Forum
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I am a 41 yr. old female with an unusual set of symptoms. Maybe someone can help me. A few yrs ago I was experiencing numbing and tingling in my right arm. It lasted on and off for a yr or two and is now virtually gone. We put it off to a positional problem, like when I dryed or curled my hair and my arm was upright, or I slept on it wrong, etc. About a yr ago I experienced a very bad pain in my right shoulder. It came on suddenly one afternoon and by midnight I was in a lot of pain. I went to the orthopedic dr. who thought I had a rotator cuff injury. I explained that I had done nothing to injure it, it just came up on it's own, but he thought perhaps I had twisted the wrong way or just didn't know I had done it. In a few days the pain went away. I had the same thing happen 3 or 4 more times, about once a month or so. We still thought it was a rotator cuff injury, even though I did nothing to provoke it. In July, a strange thing happened. I had the exact same symptoms, but this time it was in my other shoulder, I thought this was very bizarre, but the dr. thought perhaps I was using that arm more to compensate for my other arm, it sounded logical to me, I let it go at that. In September, I had a very bad bout of pain in the right shoulder again, this time I was unable to get in to see my orthopedic dr. and went to my regular dr. (he had a sub- specialty in arthritis). He noticed that the shoulder was swollen and proceeded to extract some fluid from it. It was very yellow in color. He looked for crystals in it, but found none, ruling out gout. He sent it to the lab, the tests came back with an extremely high white blood cell count, over 224,000. My blood test came back pretty normal, a low iron count was about it. Since Sept. I have had several more bouts of pain in both shoulders, it lasts for a few days, the first night is almost unbearable, but then it gets better over the next few days, virtually disappearing. I also have felt the same pain near my knee and even more strange is the feeling of pain on the bottoms of my feet, as if they are bruised. My hands are always stiff, especially in the morning, but there is a family history of osteoarthritis in my family and I always put it off to that. It seems to be getting much worse, in fact all the symptoms are getting worse. I had several weeks between these bouts earlier in the last years, now I have pain in one place or another almost all the time. My ortho dr. also extracted fluid and again, there was the extremely high white blood count in the fluid, but not in my blood. Gout tests, lyme tests, rhumatoid arthritis tests were all negative. What do I have???? I am sorry this is such a long post, but everyone here seems to be baffled and I feel like I don't want to keep bothering the two drs., but yet I am in real pain and feeling very anxious. I just want to know what this is, then I can deal with it.....Thank you VERY much for listening, any help would be very appreciated....
Thanks for your question. Your problem does not appear neurological in nature. The present of elevated WBC in your sinovial fluid indicates a fairly significant inflammatory process. Your problem would definitely be better addressed by a Rheumatologist. If you have not had any blood tests done yet, then an initial batch of "acute phase reactants" such as sedimentation rate, c-reactive protein would be an appropriate first step. I hope this informatio is helpful. Best of luck.
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