Sore muscles, skin issues, nasal drip with no explanation.

[HBR_37]

33 year old male on the 1/3/07 I came down with a cold, no fever that I could determine, a couple of days into it my left elbow started aching, my other joints and muscles became sore (over next week or 2), my armpits felt like they had lumps in them, but nothing was present.  About a month into it my groin started to hurt, I had pain in my left testicle and was sore in the groin area, also the inside of my thighs were very sore as well. The skin on my scrotum became very sensitive and the shaft of my penis was aching, no discharge, also skin was much redder than normal. I had my doctor look at this and he couldn't see anything out of the norm. The pain in my groin and testicle went away, but the muscle-joint pain remained, nasal drip is also associated with the muscle pain ,it drips worse when the pain is worse. Groin-testicle pain came back in March but subsided again, also began to get a cold tingly feeling on the skin where I was having pain,which would come and go. Middle of March had another blood test WBC/Sed-normal. I have been tested for arthritis and rheumatoid arthritis, with negative results. Saw a rheumatologist at the end of March, he tested for parvo and thyroid both results were negative. I also went to see a urologist, everything looked ok to him. Muscle pain subsided for a few days in February(3 days), but came back. The skin on my stomach, arms and chest and armpits has become sensitive and feels like it is burning and sometimes itchy like fiberglass was in it (started last week). Throughout the day my left wrists will have red dots appear then go away. My muscles now feel like they are cramping. My skin seems more modeled than before(arms and chest),the veins in my nose are more pronounced, and a pit is developing in the side of my nose. Symptoms tend to get worse when I am stressed or tired. These symptoms lately tend to come and go throughout the day, worse at night.I had negative HIV, HEP C and Syphilis tests on 1/28/07,and neg HIV on 3/28/2007

[lionF]

A related discussion, Outcome of inquirer was started.

[jah_rasta]

A related discussion, ore muscles, skin issues, nasal drip with no explanation was started.

[daveward]

A related discussion, Same problem was started.

[HBR_37]

Sorry for the additional post, I was also wondering about the possiblitiy of polyarteritis nodosa? Is it possible for this to occur with normal Sed rate and WBC count?

[HBR_37]

Thank you for you quick response, I have had all STDs ruled out by the doctors I have seen so far as well as the STD forum MD Dr. H  I have had a urinalysis by the urologist which came back normal, are the ANA tests you refer to different from the arthritis and rheumatoid arthritis and thyroid tests that I have had already? Currently what I have on my skin has not been considered a rash, but just modeling by my doctors, the dots on my wrist seem to come and go and do not itch(they are not raised either) .The itching and cool tingling that does occur does not have a noticeable rash associated with it. What has been told to me so far is that this may just be a virus that I picked up and will have to run its course, but the amount of time this has been going on seems to be excessive. I would also like to add that up until the end of November I was on Symbyax for anxiety and depression, I went off of the medication; since this has started I have had considerable anxiety over this issue as well.  I have read that low serotonin levels may also be a trigger for fibromyalgia, would this be out of the realm of possibility?  I should also note that my father has Multiple Sclerosis and I live in the Pacific NW.

[Kevin Pho, MD]

I agree with the testing that have been done thus far.  

To evaluate the GU symptoms, imaging the scrotum can be considered.  Any abscess or infection, as well as cysts, hydroceles or varicoceles can be seen on an ultrasound.

Obtaining urine tests as well as urethral swab can be done to look for urethritis as well as STDs.  

The prostate can also be evaluated via a digital rectal exam.  A prostatic massage can be done and the prostatic fluid sent for analysis and culture.  If there is suspicion of an abscess, a transrectal ultrasound can be considered.  

Regarding the burning sensation, a referral to a neurologist to look for possible neuropathies can be considered.  Blood tests looking at thyroid disorders, B-12 levels and diabetes can be considered as well.  You can also consider nerve conduction studies as well.

As for the joint and skin symptoms, blood tests can be done looking at the ANA levels and rheumatoid factor - which can be indicative of rheumatologic disorders.  Skin biopsies can also be considered to evaluate the rash.

These options can be discussed with your personal physician.

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_