Chest pain for 9 months

[GStone0971]

Help! I'm at my wits end. In November 2008, I had chest pain and thought it was a chest cold. In late December it was still bothering me so I made an appt with my physician. He said it was costochondritus. I was told to take ibuprofen for a few weeks.Didn't help. I was sent for a sonogram of my heart, it was normal. I was sent for chest x-rays, they were normal. I was put on a course of prednisone. Soothed the pain at the higher doses then came back as I weened myself off the prednisone. (Also, I completely lost my appetite and lost 10 lbs.) I was put on another course of prednisone. Soothed the pain at the higher doses then came back as I weened myself off the prednisone. (This time I couldn't get enough food and gained back the weight.) Then I was referred to a physical therapist. They didn't know what to do for costochondritus. For about 5 weeks, I'd go to the PT office 3 x per week and have an iontophoresis patch applied. I had to keep in on for 4 hours while the medication was "pumped" in to my chest. Soothed the pain slightly, but never greatly improved. I'm at the point where I'm not myself. I don't do thing that I normally would like workout, kayak, etc. as I know the pain and discomfort will come. I am now 15 lbs heavier than my standard weight. I have to sleep in an awkward position and if I move in the night (and I do) the pain wakes me up. I was given medicine to help me sleep and dull the pain (amitriptyline), but it doesn't always help. I know I'm getting paranoid and cranky from lack of sleep. Now I'm being sent to a rheumatologist. I'm concerned that there may be another issue in play. Possibly something with: lung, lymph nodes, cancer, etc. What questions should I be asking the doctors? Should I request a CAT scan?
Thank you for any and all suggestions you have for me.
Fin

[Dr Vinod]

Dear GStone0971,

Greetings from Rheumatoid arthritis forum. We would want to tell you that the problem with some people is there is no proper diagnosis available for their cause and this inturn leads to stress. In your case the Physician could not find anything clinically in your heart and the X-ray was clean so there was every possibility of costochondritis. If it did not help with Physiotherapy, rest and with anti inflammatory drugs then you might need expert opinion and proper diagnosis. Do not worry and you are doing good till now and we would advice you to go for Rheumatologist, other chest specialists for proper diagnosis.

We can advice you about Rheumatoid arthritis. Rheumatoid arthritis can also produce diffuse inflammation in the lungs, pericardium and pleura.  
Most commonly, small joints of the hands, feet and cervical spine are affected, but larger joints like the shoulder and knee can also be involved, differing per individual.
Fibrosis of the lungs is a recognised response to rheumatoid disease.  Pleural effusions are also associated with rheumatoid arthritis.
You can go for CT Scan, and if required MRI for diagnosis of RA.
When RA is clinically suspected, immunological studies are required, such as testing for the presence of rheumatoid factor (RF, a specific antibody).

Go for these tests to rule out Rheumatoid arthritis and best of luck!
Come back to us for further queries. Take care!

[GStone0971]

Thank you for your response and your best wishes!