Tuesday, May 29, 2012

Monday, August 16, 2010 Denise asks

Q: Help-my RA came back neg but the pain is unbelievable. I need a diagnosis

Please help.  I woke up one morning and both hands were inflammed and very painful.  I cannot bend my fingers, and the pain is there most of the day.  I have pain during the night.  My dct ordered blood work about 2 months ago and informed me that the results were negative and that I had a mild case of osteoarthritis.  I wake up every morning with swollen fingers, the pain is mostly at the bottom of my fingers and the joints - when I apply pressure, the pain is excrutiating.  I also have pain in both feet, mostly in my toes.  I have been extremely tired and absolutely 0 energy.  I also have narcolepsy...so it is difficult to address the fatigue issue.  My fingers "pop out" of joint when I try to bend them.  Please help me understand what is happening to me.  I am 53 years old and was always in excellent health.  I am depressed and in constant pain.

Tks

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Answers (2)
8/16/10 5:53pm

Pain, stiffness and swelling in the morning, certainly sounds suspicious for some type of arthritis. There are many reasons to have arthritis besides just worn out joints causing osteoarthritis. Auto-immune diseases like lupus are one possibility. Gout or another metabolic condition can lead to joint distruction. Infections such as Lymes disease are another possible cause of arthritis.

 

With all these possible suspects, a specialist is needed, a Rheumatologist to be exact. Some primary doctors just order a basic panel, but do not dig deeper. Sounds like you need to find a doctor willing to dig a little deeper with a more thorough investigation.

 

Dr. Christina Lasich, MD

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12/11/10 11:44am

Hi ...tks so much for responding to my email.  We are now 3 months later.  I have an appt with a specialist this coming Monday.  Since I wrote this email, I have recovered (uncertain as to why??) however, I did have cortizone injections in my middle finger on both hands since I couldn't stand the pain any longer.  This whole episode lasted about 4-6 weeks.  I lost weight, I was always exhausted and slept most of the time.  I couln't use my hands at all, and at night I had trouble even trying to pick up the blankets.  I have no clue what happened during that time.  I still have "trigger fingers" in some of my fingers on both hands but besides that...I feel better.  I have no idea what happened during that time and anxious to see the Rheumatologist .  Will let you know what they said.  Tks again for your response.  Denise

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V, Health Guide
8/29/10 9:16am

Hi, Denise.  I had the same symptoms this Spring.  I have generalized osteoarthritis, but this pain was different. I was out of town for the weekend when it hit me hard.  It had been raining all day and that evening I had to hobble around on feet that were  incredibly painful. I discovered hard white knots at the joint in my toes (up by my foot) on the 2 middle toes on both feet. I could not open bottles w/my hands. It was really freaking me out. So.....went to GP who ordered blood tests. All were normal except the one CRP, I think, that showed inflammation. She sent me to a rheumatologist. He diagnosed erosive inflammatory arthritis, generalized osteoarthritis and fibromyalgia. I am taking 200 mg of Plaquenil twice a day and it has worked wonders. It takes a while to kick in, but it is one of the safest DMARDs (disease modifying antirheumtic drugs ).  It is actually an anti-malarial drug but it works on inflammatory arthritis for some reason.  I also take a med for the fibro and an occasional tramadol if the pain gets out of hand.  I don't think the docs have completely ruled out RA, but for now this is the diagnosis. You can have such a thing as sero-negaative RA. RA is not diagnosed solely on the basis of blood tests. I know you must be in a lot of pain.  Please make an appointment with a rheumatologist asap.  There are over 200 autoimmune diseases and they can be a bear to diagnose, as they can have overlapping symptoms.  Best Wishes. Let us know how it goes.  V

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12/11/10 11:45am

Hi ...tks so much for responding to my email.  We are now 3 months later.  I have an appt with a specialist this coming Monday.  Since I wrote this email, I have recovered (uncertain as to why??) however, I did have cortizone injections in my middle finger on both hands since I couldn't stand the pain any longer.  This whole episode lasted about 4-6 weeks.  I lost weight, I was always exhausted and slept most of the time.  I couln't use my hands at all, and at night I had trouble even trying to pick up the blankets.  I have no clue what happened during that time.  I still have "trigger fingers" in some of my fingers on both hands but besides that...I feel better.  I have no idea what happened during that time and anxious to see the Rheumatologist .  Will let you know what they said.  Tks again for your response.  Denise

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By Denise— Last Modified: 12/27/10, First Published: 08/16/10