Doctors Lounge - Rheumatology Answers
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Forum Name: Rheumatology Topics
|amoshti - Wed Dec 31, 2008 7:01 am|
GOOD MORNING GOOD AFTERNOON
SINCE 9 WEEKS I STARTED TO FEEL SOME PAIN IN MY RT ELBOW -- IT IS NOT A TRUE JOINT PAIN ( AS I THINK ) BUT SEEMS TO BE TENDONITIS AND IT IS PAINFUL ONLY ON TWISTING FUNCTION (( I THOUGHT FIRST THAT IT IS DUE TO STRONG ACT DURING SEXUAL INTERCOURSE WITH MY WIFE )) 3 DAYS AFTER I FEEL BETTER REGARDING PAIN BUT RETURNING BACK AFTER ONE WEEK AND AGAIN I THINK THAT IT IS BECAUSE OF HARD WORK IN WRITING DURING THE PREVIOUS DAYS....
NEXT DAY I DO SOME HEAVY ACTION WITH MY LT ELBOW AND I HEARD SOME CRACKING SOUND AFTER THAT I FEEL SAME COMPLAIN OF RT ELBOW BUT DURING THE NEXT DAYS I START TO FEEL SOME STIFFNESS IN RT ELBOW MORE THAN LT ONE AND IS INCREASING IN INTENSITY WITH DAYS ONE TIME IT SETTLE DOWN AND I DIDNOT FEEL ANY STIFFNESS AND I REMEMBER THAT DAY IS THE DAY AFTER A HOLIDAY SO THERE IS NO HARD WRITING WORK AND I THINK THAT I NEED MORE REST
AFTER ONE WEEK I START TO FEEL SOME PAIN IN MY FOOT BOTH OF THEM LOOK LIKE THAT I WALK A LOT DURING THE PREVIOUD DAY BUT I DID NOT.
THIS PAIN MAINLY IN STANDING POSITION OR IN WALKING
ONCE I SIT THERE IS NO PAIN
WHEN I STAND I FEEL THAT MY BONE OF THE LEG TOUCH THE BONE OF FEET
AND IF I SIT THIS FEELING GONE ...
2 DAYS AGO I FEEL THAT I CAN NOT GRIP WITH MY HAND AS USUAL IN BOTH HANDS
( BY THE WAY FROM THE FIRST DAY I FEEL STIFFNESS IN BOTH RING FINGURES ONLY WITHOUT SPECIAL EXPLANATION )
TODAY MY FAMILY NOTICE SOME PUFFINESS IN MY HANDS...
I READ A LOT ABOUT R A AND I AM AFRAID THAT I HAVE IT
MY QUESTION IS MY DAIGNOSIS IS R A
AND IF SO ------ WHAT ABOUT MEDICINE USED FOR RA AND THE SIDE EFFECT
NOT THE NSAID BUT THE DMARDs AND SPECIALY IF THEY AFFECT SEXUAL ACTIVITY OR NOT
WITH MY BEST THANKS AND REGARDS
I STARTED DICLOFENAC 50 MG TWICE + TYLENOL 500MG TWICE + VOLTAREN GEL TWICE
ONLY POSITIVE FEATURE IN MY FAMILY HX IS THAT MY LITTLE DAUGHTER HAD POSITIVE RF
MY LAB TEST IS AS FOLLOW
FIRST ESR 13
URIC ACID 4.2
LIPID PROFILE NORMAL
R F NEGATIVE
AFER 5 WEEKS
URIC ACID 4.7
I AM WAITING FOR YOUR ANSWER
WITH BEST THANKS AND REGARDS
|Tom Plamondon PA-C - Fri Jan 02, 2009 3:36 pm|
Thanks for your questions.
Regarding the lab work: the ESR and CRP are non specific markers for an inflammation process. They help monitor progression/regression of inflammatory disease (eg lupus, RA, gout) but limited use in diagnostics.
Besides rheumatoid factor, ANA and anti-CCP are two antibody blood tests that help with diagnosing RA.
Clinically, we look for multiple small joint arthritis in the hands and feet. We look for symmetrical involvement vs just one side of the body affected. Any morning joint stiffness lasting for more than one hour. Xrays or the hands and feet are also important. Finally, are there any nodules under the skin near the arthritic joints. This is not to say that the RA can not be in the elbow or knees but usually attack the smaller joints.
DMARDS stands for disease modifying anti-rheumatic drugs. These include methotrexate, Plaquinil, sulfasalazine and others. If the diagnosis of RA is made, it is important to see a rheumatologist to consider DMARDS. Early intervention may prevent bony erosions in the joints and stop the RA disease.
Each medicine has its own unique profile (risks and benefits) and should be discussed with the physician prior to starting.
All the best to you.
Keep us posted.
|amoshti - Fri Jan 02, 2009 5:17 pm|
THANK U FOR RAPID ANSWER AND INTEREST
REGARDING NODULE THE ANSWER IS NO
I DID ESR YESTERDAY AND IT WAS 16 ( LOWERED FROM 30 TO 16 )
R F WAS - VE
MY CBC WAS NORMAL NO ANEMIA
REGARDING STIFFNESS I CAN NOT GIVE THE EXACT TIME BUT IT DECREASE ALOT WITHIN ONE HOUR
MAY BE I CAN NOT GIVE THE EXACT MEANING OF STIFFNESS BUT FRANKLY SPEAKING THE PAIN IN ELBOW BOTH OF THEM REMAIN THE SAME IN ANY STRONG ARM ACTION EVEN IN REACHING FAR OBJECT SUDDENLY
FOR THAT I TOLD U IN BEGINING OF MY STORY THAT I THINK FIRST THAT IT IS ONLY TENDONNITIS
BUT WHEN FOOT PAIN START MY MIND TURNED TO R A
WAITING FOR UR ANSWER AND APRECAITING UR INTEREST
|Tom Plamondon PA-C - Sat Jan 03, 2009 1:27 pm|
Certainly tendonitis can cause the elbow pain you have described especially with repetitive or strong action.
The most common tendonitis is lateral epicondylitis (tennis elbow). Tenderness is located on the outer aspect of the elbow. Gripping and many hand grasping maneuvers aggravate the pain.
Treatment includes ice, rest, NSAIDS, and gentle stretching and strengthening exercise. Tennis elbow brace helps. For chronic tendonitis alternating heat and ice packs helps.
Having a physician or orthopedist evaluate the elbow would help clarify the diagnosis.
Let us know how it goes.
|amoshti - Sat Jan 10, 2009 2:50 pm|
TODAY AT EARLY MORNING I FEEL SOME PAIN IN MY ELBOW
MAY BE BECAUSE OF SOME HARD ACTION IN SEXUAL INTERCOURSE LAST NIGHT
I FEEL BETTER REGARDING THE ELBOW PAIN DURING THE LAST FEW DAYS AND I THINK IT WAS DUE TO EXTRA REST DURING THOSE DAYS .
REGARDING ANA AND A- CCP I HAVE AN APPOINTMENT ON THE END OF JANUARY .
I WILL DO X_ RAY FOR MY HANDS AND FEET .
FRANKLY SPEAKING I AM REALY AFRAID FROM HAVING R A
BY THE WAY ... IS THERE IS RELATION BETWEEN SEXUAL ACTIVITY AND ARTHRITIS I READ ABOUT REACTIVE ARTHRITIS AND IN TRUTH I HAVE TWO WIVES
MY CONDITION STARTED 2 - 3 MONTHS AGO AND AT THAT TIME THERE IS SOME INFECTION IN ONE OF THEM
BUT AGAIN I READ THAT THIS TYPE OF ARTHRITIS HAVE SEPTIC FEATURES AS FEVER TENDERNESS SWELLING .... ETC
AND I HAVE NOT YET SO I DISCARD THINKING OF THAT
TODAY MY TESTS WERE
CRP STRONG POSITIVE
I AM ON OLFEN TAB. 50 MG TWICE
TYLENOL 500 MG TWICE
TRAUMEEL (WHICH IS HERBAL ANTIINFLAMATORY MED.) THRICE
WAITING FOR UR KIND ANSWER
WITH MY BEST THANKS AND REGARDS
|amoshti - Fri Jan 23, 2009 5:32 pm|
good morning good evening
i want to thank you for ur patient and good responce
although nobody answer my last request
i will not write again in this topic and i want to thank u too much
your s amoshti
|Tom Plamondon PA-C - Mon Jan 26, 2009 5:37 pm|
Thank you for the case.
Let us know if we can be of further assistance to you.
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