Undiagnosed - Tender Sternum, Shoulder, Armpit, Joint Pain

Question

Wondering if anyone else has similar symptoms.  I have gone undiagnosed with a number of symptoms since May.  Started out as burning feeling around collarbone and then down through sternum area.  Does not feel like heartburn, tender when touching.  I also get a weird taste on tongue, pain behind my left shoulder blade, a dull burning type sensation in armpits, tendon (maybe joint) pain in wrists/ankles, abdominal tightness on both sides, and discomfort in shins.  I have also noticed increase in floaters in left eye.  When one of these symptoms starts to increase intensity it seems like they all do.

I have had EKG, Chest CT, MRI Brain, Bone Scan, Upper Endoscopy, Colonoscopy, Abdominal MRI and number of blood tests (CBC, Iron, B-12, autoimmune, vit-D, Lyme, etc)..all unremarkable.  I have seen an ENT, Gastroenterologist, Neurologist, Rheumatologist, and ongoing visits with family doctor; however, still nothing.  Anyone have something similar or any suggestions on where I can go from here?  After so many months I am about to give up and just accept I have to live with this; however, I keep thinking I want to keep digging in case something serious.  I am getting a lot of anxiety over all these symptoms.  The only thing I am taking right now is Nortriptyline which was just prescribed by Gastroenterologist since he thought might be caused by nerves?  Thanks for any advice!

mjaj8686 · Answer

Hi,

I pulled up all blood work they did below. I believe I have had an extensive workup; however, no diagnosis. I am not sure whether to just give up and accept or keep digging in case something serious is hiding. Would fibromyalgia cause burning/tender sensation by top collar bone and sternum as well as pain in ankles, wrists, lower back, shoulder blades? The other odd thing is weird sensation on my tongue and discomfort in armpit when all of this is happening.

Thanks!

Coagulation
Name Result Normal Range
Protime 14.7 Seconds 11.6 - 14.7
INR 1.1 0.8 - 1.1

Name Result Normal Range
APTT 30.1 Seconds 22.7 - 36.1

Platelet Function
Name Result Normal Range
Arachidonic Acid 6.0 % 70 - 96
1.2 mg/mL Ristocetin 104.0 % 71 - 110
.75 mg/mL Ristocetin 1.0 %
.5 mg/mL Ristocetin 4.0 %
5um ADP 58.0 % 63 - 96
10um ADP 98.0 % 63 - 96
Collagen, Serum 101.0 % 60 - 103
5um Epinephrine 95.0 % 59 - 103

Timed Urine Chemistry
Name Result Normal Range
U Collect Time 24 Hour
U Volume 2300 mL

Toxicology
Name Result Normal Range
U Arsenic <15 see fn
U Cadmium <0.2 see fn <3.0
U Lead <5 see fn <80
U Hg 18.0 mcg/L > or=3.5

Hereditary/Metabolic
Name Result Normal Range
HFE Specimen Blood u/L
HFE Specimen ID 841867 u/L
HFE Source NOT PERF u/L
HFE Order Date see fn u/L
HFE Release Date see fn u/L

HLA Studies
Name Result Normal Range
DDA COMPLETE

Special Chemistry
Name Result Normal Range
Cort AM 12.4 mcg/dl 7.0 - 25.0

General Chemistry
Name Result Normal Range
Mg Serum 2.3 mg/dL 1.8 - 2.5
Uric Acid 5.5 mg/dL 3.7 - 8.0
Na 142.0 mmol/L 135 - 145
K 4.0 mmol/L 3.6 - 5.2
Cl 104.0 mmol/L 100 - 108
Bicarbonate, Serum 29.0 mmol/L 22 - 29
Anion Gap 9.0 mmol/L
BUN 16.0 mg/dL 8 - 24
Creatinine 0.9 mg/dL 0.8 - 1.3
Glucose, Plasma/Serum 81.0 mg/dL 70 - 100
Bili Total 0.9 mg/dL 0.1 - 1.1
Bili Direct 0.2 mg/dL 0.0 - 0.3
Ca 9.2 mg/dL 8.9 - 10.1
Estimated GFR > 60 ml/min

Protein Electrophoresis
Name Result Normal Range
TP 6.8 g/dL 6.3 - 7.9
A1 Globulin 0.18 g/dL 0.10 - 0.30
A2 Globulin 0.93 g/dL 0.60 - 1.10
Albumin Electrophoresis 4.08 g/dL 3.40 - 4.70
A/G Ratio 1.49
Gamma Glob 0.69 g/dL 0.60 - 1.60
Beta Glob 0.93 g/dL 0.70 - 1.40

Immunology
Name Result Normal Range
RF Quant <15 IU/mL 0 - 14
Tissue Transglut IgA Ab <1.2 u/mL <4.0
Tissue Transglut IgG Ab <1.2 u/mL <6.0
Antinuclear Antibodies 0.2 Units 0.0 - 1.0
Cyclic Citrul Peptide Ab <15.6 Units

Thyroid
Name Result Normal Range
S-TSH 1.39 mIU/L 0.30 - 5.00
T4 Total 7.7 mcg/dl 5.0 - 12.5

Infectious Serology
Name Result Normal Range
Lyme Serology S NEGATIVE

Differential
Name Result Normal Range
Segs/Neuts 51.2 % 44.4 - 70.9
Lymphocytes Percent 39.2 % 17.8 - 41.5
Monocytes Percent 7.7 % 3.3 - 10.1
Eosinophils Percent 1.4 % 0.8 - 7.2
Basophils Percent 0.5 % 0.0 - 2.2
Neutrophils Absolute 2.7 x1000 1.7 - 7.0
Lymphocytes Absolute 2.1 x1000 0.9 - 2.9
Monocytes Absolute 0.41 x1000 0.30 - 0.90
Eosinophils Absolute 0.07 x1000 0.05 - 0.50
Basophils Absolute 0.0 x1000 0.0 - 0.1

Blood Cell Count
Name Result Normal Range
Hgb 14.0 g/dL 13.5 - 17.5
Hct 41.5 % 38.8 - 50.0
RBC 4.5 Mil/ul 4.32 - 5.72
MCV 92.3 fL 81.2 - 95.1
MCH 31.1 pg 27.4 - 33.0
MCHC 33.7 g/dL 33.3 - 35.2
RDW 12.7 % 11.8 - 15.6
WBC 5.3 x1000 3.5 - 10.5
Platelet Count 186.0 x1000 150 - 450
MPV 10.1 fL 7.6 - 10.8

Enzymes
Name Result Normal Range
AST 23.0 u/L 8 - 48
ALT 18.0 u/L 7 - 55
Alk Phos 50.0 u/L 45 - 115

Glucose Studies
Name Result Normal Range
A1C 5.3 % 4.0 - 6.0
Estimated Average Glucose 105.0 mg/dL 68 - 126

Enzymes
Name Result Normal Range
CK 171.0 u/L 52 - 336
LD 146.0 u/L 122 - 222

Lipids/Cardiac Risk
Name Result Normal Range
Trig 116.0 mg/dL < 199
Chol 168.0 mg/dL 40
LDL Calc 79.8 < 159.9
Chol/HDL 2.58

Urinalysis Macroscopic
Name Result Normal Range
CC Source UACC
U Spec Grav 1.013 1.002 - 1.030
U Leuk Est NEG NEGATIVE
U Nitrite NEG NEGATIVE
U pH 7.5 4.5 - 8.0
U Prot Qual NEG NEGATIVE
U Gluc Qual NEG NEGATIVE
U Ketones NEG NEGATIVE
U Bili NEG NEGATIVE
U Urobilino NORMAL NORMAL
U OB NEG NEGATIVE

Urinalysis Microscopic
Name Result Normal Range
Microscopy _ NEGATIVE
U WBC <1 /hpf 0-3/HPF

KMathurMD · Answer

Hi 
Welcome to the MedHelp forum!
If it is tender to touch then the pain is coming from the ribcage. Chest pain aggravated by laughing yawning, moving in certain directions, stretching and deep breathing goes more in favor of costochondritis, which causes pain and tenderness at points where your ribs attach to your breastbone.  The inflammation around the joint area gives sharp pain on taking a breath. This can also cause tenderness on pressing the area which pains. An orthopedic doctor can diagnose this for you. Generally there is no cause. However it can be due to infection, blow, injury, or fibromyalgia. It usually goes away on its own. Otherwise it can be treated with muscle relaxants, and non steroidal anti inflammatory drugs. It can also be muscle pull. Shingles can also start this way.
Other than that it can be fibromyalgia. This is associated with fatigue and a heightened and painful response to gentle touch (allodynia). Other symptoms include needle-like tingling of the skin, nerve pain, weakness in the limbs, bowel disturbances, and chronic sleep disturbances. Although fibromyalgia usually presents with chronic widespread pain, pain may also be localized in areas such as the shoulders, neck, low back, hips, or other areas. Alternatively you should be tested for gout and rheumatoid arthritis.
The cause of fibromyalgia is often hereditary or due to a physical or emotional trauma or due to lingering infection in the body such as due to mono. It can also be due to severe or long lasting anemia. The treatment is a mix and match of analgesics, anti depressants, anti seizure medications, physical therapy and counseling. Correcting anemia and treating infection also helps.
Since I cannot examine you and know other related conditions you may be having, nor is a detailed history possible on net, I have listed the various possibilities that should be looked into. Please consult your PCP to run tests and examination to clinch a diagnosis. Take care!