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Forum Name: Rheumatology Topics

Question: Swollen and painful joints...


 mitzidodl - Sat Aug 01, 2009 12:42 pm

I was diagnosed with Rheumatic Fever back in 2004. I had been having swollen and painful ankles and knees since i was 13 or 14. I was relieved when i finally had answer for my problem-rheumtaic fever. I went virtually symptom free for a couple of years. Recently, within the past year or so (maybe 2) ive been having what i thought were flare ups from the rheumatic fever. Ive had more than 4 occassions where my ankle has become swollen and painful. To the point where i cant put any weight on it. It has occured in both ankles. It usually occurs in my ankles although i have had the same problems in my elbows, knees, and now my foot and shoulder. The "flare ups" have been occuring more frequently now, to the point that i can expect to have miss work at least once a month due to this problem.
I have made numerous trips the urgent care all with the same result. Not rheumatic fever but a sprain. Earlier on, i took this diagnosis without question and figured that i just didnt remember doing anything to hurt it. Now that these episodes have been occuring more frequently, I know for sure im not doing anything to hurt myself. I wake up and the pain and swelling is there and it stays for about a week. The pain at times is so bad i wake up in the middle of the night in agony and cant get back to sleep until the ibuprofen kicks in. Its becoming a serious concern. But i cant seem to find an answer. I have been tested for Lupus, Gout, and everything that goes along with swollen and painful joints and all have been negative. If its not rheumatic fever or any of those others what could it be?
Ive come to the point that i don't even go to urgent care anymore, because there is nothing they can tell me that i havent already heard. I need some input as to what other problems this could stem from.
 Tom Plamondon PA-C - Mon Aug 03, 2009 5:31 pm

User avatar Hello,
You have described an arthritic condition in the knees, elbows, shoulders and ankles/feet.
Past medical history includes rheumatic fever.
Testing for lupus and gout have been negative.

The list of possible diagnosis for multiple joint arthritis is long.

I would ask some history questions about
    possible tick bite (Lyme disease)
    signs and symptoms of thyroid dysfunction
    skin changes (autoimmune problems)
    vision changes (autoimmune problems)

I would also review all the labs including any x-ray of the affected joints.

Another approach to the diagnosis may involve pulling fluid out of the swollen joint and analyzing it.

To pull all the information together, sift through it, and make a working diagnosis may require the consultation of a rheumatologist.

Take care and let us know how it goes.
 eyeproblem - Thu Nov 05, 2009 4:56 am

This sounds like it could possibly be something called Palindromic Rheumatism.
http://en.wikipedia.org/wiki/Palindromic_rheumatism

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