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Small joint pains - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Child Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1723 Questions
Doctor :   Hi
Doctor :  
How can I help you?
Doctor :  
It seems you moved out
User :   no sir
Doctor :  
Ok
User :   it was first time log in so took time to understand
User :   now its ok sir
Doctor :  
Ok no problem
Doctor :  
YOu can continue
User :   Sir , I have daughter of 10 years
User :   2moro is her birthday in fact
Doctor :  
ok
Doctor :  
Wishes to her
User :   Sir , she is complianing pain in fingers base / also toes for the last 4-5 months
User :   infact she did nt complain we noticed that after writing a line or two she leave her pen and just manueovers the fingers
User :   so when asked she said that it is paining / or aching
Doctor :  
ok
User :   for the first month i tghought due to study pressure , she may feel the pain as they hv to write so much in schhools
Doctor :  
ok
User :   but now it is observed she is regular in playing the fingers and says it pains - regularly
Doctor :  
Did you see a doctor since the start of the problem?
User :   just 2 days back i saw the doctor she wrote some tests for MP Tc Dc etc
User :   but later another doctor friend of me advised to test for R - factor
User :   and yesterday it came out as positive
User :   and he says it may be rheumatic pain
User :   he guesses so and was hinting at some other tests also
Doctor :  
Ok
Doctor :  
In fact I too think of the same issues
Doctor :  
when you explained about the problem
Doctor :  
Now let me ask you few more questions
User :   ok sir
Doctor :  
Did you observe the swelling and redness near the joints of pain?
User :   no sir
Doctor :  
What is the frequency of the pain?
User :   daily , as i ask sanytime around she says , yes a bit of is there
User :   even in toes
Doctor :  
Did she get a sore throat very frequently?
User :   nowhere else
User :   yes she gets sorethroat , atleast twice -thrice in a year
Doctor :  
Did you observe the pain complaints in the large joints like knee, ankles, elbow and wrist ?
User :   as and when exposed to cold
Doctor :  
It seems you moved out again
User :   no sir
Doctor :   Did you observe the pain complaints in the large joints like knee, ankles, elbow and wrist ?
User :   it went out automatically and reloaded
User :   no sir
User :   no other areas
User :   she is bit lethargic , lazy
Doctor :   Did you take a throat swab whenever she gets the sore throat?
User :   swab means?
Doctor :  
With a cotton
Doctor :  
the swab is taken and culture is sent to look for specific bacteria?
User :   no . never
User :   just antibiotic pils
Doctor :  
DId you see the doctor whenever she has the throat pain?
User :   she has tonsil problem
Doctor :  
Ok
User :   yes doctor said - tonsil problem
Doctor :  
ok
Doctor :  
Does her tongue look very red?
User :   no
User :   just pinkish as usual
Doctor :   Hwo is her appetite and stools?
User :   i mean as normal
User :   appetite is very very poor
User :   stools , once a day, sometimes skips
User :   she never wants to eat
Doctor :  
How is her weight. is it growing well wrt to other children of her age?
User :   yeah , she was 2.8 kg in time of birth and normal now
User :   growing slowly
User :   she is thin
Doctor :  
What is her current weight
User :   not skinny though
User :   let me ask my wife
Doctor :   ok

User :   Sir , she is normal , not underweight now , i m in office i will tell it later
User :   doctor didnt check it in last 2-3 months'
User :   doctor didnt check it in last 2-3 months'
User :   doctor didnt check it in last 2-3 months
User :   sir , i will tellthis later
User :   hello
User :   helllllllooooooooo
Doctor :  
Hello are you there?
User :   hello
User :   r u there
User :   hello
Doctor :  
yes
Doctor :  
I am here
Doctor :  
Please proceed
User :   seems , it was DC from otherside
Doctor :   No

Doctor :  
It is fine
User :   weight , i will tell later sir
Doctor :  
Ok
User :   i m at office
User :   but she is not underweight even
Doctor :  
I think you have to get the physical examination done by Pediatrician and if he is in doubt he can refer to Rheumatologist
User :   he was not a paediatrician
User :   he was plain MBBS
Doctor :  
Please consult a pediatrician and if he feels it is Rheumatic fever / rheumatoid arthritis
Doctor :  
then he will refer to the concerend specialist
User :   he says to get some other tests i fotrget the names , which can be done at Kolkata or sample to be sent to Mumbai - sort of
Doctor :  
Please do not neglect it
Doctor :   I know them

Doctor :  
but why do you take such costly tests without consulting expert
User :   he say otherwise
User :   he says let the tests confirm Rheumt.. after that he will refer to rheumatologist
Doctor :   It is your decision finally

User :   Sir , my question is , is there chance that it is not Rheumatic
Doctor :  
as these are costly tests and done at higher centres
User :   wht u diagnose sir , from the symptoms
Doctor :  
it is likely to be rheumatic
User :   oh my
Doctor :  
arthralgia
Doctor :  
But I am not sure without the clinical examinatino
Doctor :  
Since there is no swelling or redness
User :   thats ok sir
Doctor :   Swelling and redness should be there
User :   can it be cured or for lifelong she will suffer
Doctor :  
She has frequent sorethroat fever
Doctor :  
and she is young
User :   no swelling and redness till
Doctor :  
It is not spreading to the other joints
Doctor :  
so few point to the rheumatic and few are not
User :   not till now
User :   only fingers
User :   and toes sometimes
User :   though she is lazy but , when gets frends she runs and plays also
User :   ok

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