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Family Medicine (Expert Forum)
dont know whats wrong, any ideas?
Answered by
J.M. Keyes, MD - Family Medicine
Gainesville - FL
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
dont know whats wrong, any ideas?
by !Sandy12345, Apr 14, 2008 01:31PM
hi, 35 female
thanks for reading this . i. i have been having pain in my joints on and off for about three years now, (hip pain for 15 years, ). i have transient joint pain that migrates to diiferent parts of the body, my feet and toes have been affected in the past along with my upper back. i work with my hands and am now finding my thumb and 1st mcp joints are quite bad and can be stiff for the first hour of use , but my knees now give me trouble especially when i get out the bath (backs of knees hurt) or stand up, and my hips also especially when they are extended when walking.
i can go for weeks with minimal pain, then all of a sudden i can be in bad pain for days. i only have detectable swelling in the hand joints. i have had tests for ra, ana, c-reactive protein, thyroid , all negative. docotr has said i probably have some kind of inflammatory condition, but cannot say what and seemed to focus on it being a small joint problem (which it isnt now!). ive researched myself and my symptoms dont seem to fit into any arthritic conditon?? any ideas
1. does gout present in this way ever, i do not tend to get monoarthritis or 1st ip joint swelling of foot, but wonder whether it could be this, i do drink white wine, but not excessively
2. becuase i have been labelled an atopic asthmatic, my doctor is reluctant for me to take ibuprofen (which does help), has instead suggested taking 8 paracetomol a day for a month, but i am not happy about doing this cos i am worried about the strain on my liver, so i rely on over the counter voltarol gel, can you think of any (stronger) alternatives???
3. is there any credence to avoiding acidic foods, for inflammotry conditons
4.seem to have developed asthma, and allergies later in life do you think allergy could play a role in transient joint pain.
5. if i dont use anti inflammatories very much , is it possble that joint deformity would be worse than if i was taking something
thanks for your help
thanks for reading this . i. i have been having pain in my joints on and off for about three years now, (hip pain for 15 years, ). i have transient joint pain that migrates to diiferent parts of the body, my feet and toes have been affected in the past along with my upper back. i work with my hands and am now finding my thumb and 1st mcp joints are quite bad and can be stiff for the first hour of use , but my knees now give me trouble especially when i get out the bath (backs of knees hurt) or stand up, and my hips also especially when they are extended when walking.
i can go for weeks with minimal pain, then all of a sudden i can be in bad pain for days. i only have detectable swelling in the hand joints. i have had tests for ra, ana, c-reactive protein, thyroid , all negative. docotr has said i probably have some kind of inflammatory condition, but cannot say what and seemed to focus on it being a small joint problem (which it isnt now!). ive researched myself and my symptoms dont seem to fit into any arthritic conditon?? any ideas
1. does gout present in this way ever, i do not tend to get monoarthritis or 1st ip joint swelling of foot, but wonder whether it could be this, i do drink white wine, but not excessively
2. becuase i have been labelled an atopic asthmatic, my doctor is reluctant for me to take ibuprofen (which does help), has instead suggested taking 8 paracetomol a day for a month, but i am not happy about doing this cos i am worried about the strain on my liver, so i rely on over the counter voltarol gel, can you think of any (stronger) alternatives???
3. is there any credence to avoiding acidic foods, for inflammotry conditons
4.seem to have developed asthma, and allergies later in life do you think allergy could play a role in transient joint pain.
5. if i dont use anti inflammatories very much , is it possble that joint deformity would be worse than if i was taking something
thanks for your help
Doctor's Answer
by J.M. Keyes, MD, Apr 14, 2008 04:02PM
, Apr 14, 2008 04:02PMTo: !Sandy12345
I am sorry to hear that you have this problem. It must be very frustrating for you. I don't know that I can fully answer all of the questions you posed, but I'll try to give you a general idea of my opinion on the situation.
It seems that whatever your diagnosis, it is likely an atypical presentation. This doesn't sound like gout, and it is uncommon for someone as young as yourself to suffer so much from gout. Gout is usually mono-articular, as you mention, but after years it can affect several joints. The only real way to have that ruled out is to have a joint that is actively painful/swollen etc aspirated (fluid removed with a needle) and the fluid examined under a microscope.
About 25% of people with RA have a negative rheumatoid factor, so I think this is still a possibility with you, especially with the morning stiffness and joint deformity.
If you do have RA, there are medications that will slow down joint deformity (that aren't anti-inflammatories, so I would have this further looked into. I would suggest seeing a rheumatologist. In the meantime, because of the asthma, I would stick to your current regimen of treatment suggested by your doctor.
Best of luck with this.
JMK MD
It seems that whatever your diagnosis, it is likely an atypical presentation. This doesn't sound like gout, and it is uncommon for someone as young as yourself to suffer so much from gout. Gout is usually mono-articular, as you mention, but after years it can affect several joints. The only real way to have that ruled out is to have a joint that is actively painful/swollen etc aspirated (fluid removed with a needle) and the fluid examined under a microscope.
About 25% of people with RA have a negative rheumatoid factor, so I think this is still a possibility with you, especially with the morning stiffness and joint deformity.
If you do have RA, there are medications that will slow down joint deformity (that aren't anti-inflammatories, so I would have this further looked into. I would suggest seeing a rheumatologist. In the meantime, because of the asthma, I would stick to your current regimen of treatment suggested by your doctor.
Best of luck with this.
JMK MD
Member Comments (1)
by BABYDOLL08, Sep 20, 2008 10:04AM
A related discussion, pregnancy related was started.
