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Stiffness and pain in her right thigh. High ESR level. What can be done? - Online Doctor Chats

Date : 06-Jun-2013
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2009
Answered : 983 Questions
User:Good Morning Doctor
Doctor:Dr XXXXXXX here
Doctor:Good morning.
Doctor:How can I help you?
User:I have a query regarding ortho..
User:for my wife..
Doctor:Please proceed.
User:She was having stiffness and pain in her right tigh for which we saw a doctor lasr week & prescribed following investigations :
User:X XXXXXXX Pelvis B/L hips; C-Hemogram ESR; CRP; RA Factor; T3 T4; TSH; Anti CCP; 250 H Vit D3 Level
User:All parameters are perfect except ESR (westergen) which is at 45 & the limite is
User:Also Rheumatoid Factor is at 39.1 & the limit is
User:Rest all is perfect...
User:Also, doctor said that he suspects joint pain tendency after clinical observation..
User:wat could be the reason and meaning of these 2 deviations ?
Doctor:ESR is an inflammatory marker which gets elevated due to wide variety of causes.
Doctor:Further positive RF also indicates inflammation.
Doctor:The cause for this inflammation needs to be evaluated.
Doctor:RF factor is closely associated with rheumatoid arthritis; however as Anti-CCP antibody is negative,
User:What does inflammation exactly means doctor ?
Doctor:rheumatoid arthritis is doubtful.
User:Ok...what is that ?
User:And what kind of treatment is there for this disease ?
Doctor:Inflammation is a generalised body response of the body against any infection and injury.
Doctor:Occasionally such response can be triggered against normal body tissues too.
User:Is rheumatoid arthritis serious in nature ?
Doctor:Yes, Rheumatoid arthritis is a chronic condition and when not treated adequately it can result in complications.
User:How long is the treatment ?
Doctor:That being said, currently we have enough treatments to keep the disease in control.
Doctor:The treatment of rheumatoid arthritis can be in months to years.
Doctor:Sometimes it may be for life too.
User:Ok....and does this disease develops immediately & over a period of time ?
Doctor:It is a chronic condition where the symptoms are present for a while.
User:and what could be the compilactions ?
Doctor:It can have periods of aggravation and remission; where symptoms can flare up and decline.
Doctor:Complications are usually localized to the joint. It can cause the patients to be immobilized - due to pain, stiffness and deformities.
Doctor:This can spread to other joints.
User:I stay in Gurgaon; any suggestion from which treatment can be taken...i have seen a ortho specialist in XXXXXXX Gurgaon as of now..
Doctor:And rarely this can affect other organs such as lungs, skin, heart, etc.
Doctor:Currently I suggest you to continue with the same doctor.
Doctor:In addition to that, she may also need to consult a rheumatologist.
Doctor:I am sure XXXXXXX hospital will have this specialty doctors too.
User:Sure we will do that...
Doctor:This combine approach - rheumatologist and orthopedician along with physiotherapist
User:Any Precautions we need to take ?
Doctor:will be able to solve her problem.
Doctor:As of now, there are no much restriction.
Doctor:The primary aim is to find the root problem and start treatment.
Doctor:Physiotherpy experts will recommend her some exercises which needs to be done religiously.
User:Sure..i do have an appointment today @ 1130 hrs with ortho specialist..
User:And she is working which needs commutation on that fine ?
Doctor:Do visit them. As an examining doctor, he/she will be able to comment more (relating her symptoms with the reports)
Doctor:it is more likely that she may not have these conditions (the values are not significantly risen)
Doctor:You may also discuss the option of visiting the rheumatologist today.
User:Ok i will do that also...
User:Any other suggestion please ?
Doctor:And also discuss about visiting a physiotherapist.
Doctor:Over the net, without an opportunity to read her examination details I am unable to comment more.
Doctor:Once the consultation is done, you can discuss with me further.
Doctor:Hope it is clear.
Doctor:Do you have any other queries?
User:Sure Doctor i will do that....i will try to connect with you again later in the day after seeing the doctor..
User:Thanks a lot for your valuable time and presious suggestions and guidance..
Doctor:You are welcome.
Doctor:Thanks for consulting me.
Doctor:Bye for now.
User:Thanls Dr. XXXXXXX and wish you a very Happy Diwali..
Doctor:Wish you the same.
Doctor:Thank you.
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