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Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me?

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Rheumatologist
Practicing since : 1985
Answered : 45 Questions
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Dear sir, madam,

I like to consult regarding some joints pain and general issues in the last montsh. Started with hp infection, then night sweating, and chills. Now warm and joints pain. I did all tests ...blood x 10 petct ct abdomen all ok. Recenty i went to reumatologist and he ordered rf test. It shows 43 abnormal result but the cpp is ok. I have normal ...in range wbc and slighly high acid uric 7,9.


I am really struggeling, joints warm And pIn, solty eyes etc.... Can u help me?


Specifically n the hand toe i have pAin. I was consulting dr XXXXXXX XXXXXXX and he has my case. I can send alos the latest results if needed. But basically i have all blood test in norm but for rf which is 43.


To summariZe.
..eyes burning
..wrist and toe connected to rist pain and burn
..chills sometimes
..feel hot on the top of my back sometimes
.. Warm ankels
..tired, have power but more fatigue
..i feel in my feeld, ankles like bowel movement feeling....
..left ear beeps and have acid liquid comming out
..all joints cracking

Thanks
Posted Sat, 11 Aug 2012 in Lupus
 
 
Answered by Dr. Praveen Jadhav 23 hours later
Dear XXXXXX,

From your symptoms, it appears that you are suffering from rheumatoid arthritis. Sometimes, anti ccp can be negative and rf test can be positive.

You need to consult rheumatologist as early as possible to start medications called DMARDs. These include medications such as methotrexate, choloroquine, leflunomide, and sulfasalazine. These need to be taken under supervision of rheumatologist.


I am sure, with proper guidance from rheumatolgist, you should do well.

Dr Jadhav
Above answer was peer-reviewed by
 
Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 1 hour later
Dear Sir,

thanks for your opinion. Indeed, all started with severe bacterial infection back in Feb.
I wanted to update you on few tests I;ve done ... since the very beginning they did XXXXXXX XXXXXXX -> both negative. My uric acid was always ok but the last test shows slight elevation (not sure why, but i was on diet last days since I gained lots of weight). Never had CCP done or RF done, Now for the first time. The only result I am waiting now is the HLA-b27 and lupic.

from symptoms stand point,m joints started to be painfil only 2 months ago... so may be this has progessed now more rapidly...

I have few questions on this:
-> based on the facts, how certain are you this is the problem ? I am suffering from missing dignostic for long time now... so this is the first time i have any clue.
-> XXXXXXX XXXXXXX and PETCT can miss this ?
-> How XXXXXXX is this condition ? I am 30, is this life treatening or terminal ?
-> Is this treatable, would it let me die young ? how many years I got ?
-> What complications may this desease lead to ? Cancer ?

Lastly, what is the cause of this desease ?

thanks a lot.
Lastly, can i consider goiput s well??? Can i have ear acid from ra?
 
 
Answered by Dr. Praveen Jadhav 16 hours later
You definitely have symptoms and hence some problem. Till now, it was not defined. The diagnosis is largely based on clinical features rather than reports of the test. In that sense, there is a strong possibility that you may be suffering from rheumatoid arthritis.

Negative XXXXXXX XXXXXXX and CT rules out lupus, vasculitis and some other immunological diseases as the cause of your problem. These are something different than rheumatoid arthritis.

It seems you are developing a lot of anxiety because of the symptoms. This problem is definitely treatable and you can live your normal destined life. Sometimes rheumatoid arthritis is associated with a condition called fibromyalgia, which has associated symptoms of anxiety.

There could be some complications such as affection of nerves, dryness of mouth and eyes, swelling of pleura, etc. It is too early for you to have these complications and you should not worry about them right now. Cancer is a very very rare complication and again, it should not be thought of so early.
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Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 17 minutes later
Thanks. What cancer type??
In fact I have salty eyes for months now...
 
 
Answered by Dr. Praveen Jadhav 14 hours later
Lymphoma.

If you mean dryness of eyes as salty eyes, it does fit into the picture of rheumatoid arhtritis.
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Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 2 hours later
HI Again,

I have my appointment this coming Thursday with Reumathologist.
Hopefully I will have HLA B27 by then.

Again, I would like to ask you based on the symptoms and blood tests:
is RA your best diagnose at the moment. I summarize them again below:
Symptoms:
- Ear beep with acid liquid coming out
- Salty eyes (since Feb -> come and go not all the time)
- Nights Sweats (now very rare but back in Ar/May was every night)
- Fatigue
- warm in the joints and bones (mostly in the anckles sometimes upper back, close to the neck). In fact, when I was sweating it was on the neck and chest.
- Chills and feel cold, w/o any fever. Chills go down to the legs, when I touch my back.
- Had some stomack issues back in March but now is perfectly fine.
- sometimes in the morning feel low pain on the kidney area.

Blood:
- seems the only abnormality for now is the Acid Urique and RF.
- I attach the latest ones.

Thanks for you help in advance.
forgot to answer, is there a link between Acid Urique and RF >????
Lastly, the Anti CCP is missing in the test file above, but it is 1.
thanks

 
 
Answered by Dr. Praveen Jadhav 9 hours later
Rheumatoid arthritis is a likely diagnosis. Though you have not specified the involved joints, I presume most of the joints are warm, tender and swollen.

Have not understood what you mean by ear beep and acid liquid coming out. If you mean that there is a discharge from the ear, you need to consult ENT specialist urgently. This symptom does not fit in RA. Rest of the features can be found in RA.

There is no relation between uric acid and RF.
Above answer was peer-reviewed by
 
Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 2 hours later
Hi,
In fact it all started as bacterial infection back in feb. since then i had salty eyes, some stomach prolems which were gone meanwhile. Fro two months, i did some tests meanwhile incl. petct and ct abdomen, i have this joints story.

In fact, after i stoped the helicobacer antibiotics back i march,i started night sweats and chills on the back + hot feeling. It is like i feel weak bones and joints, and specifically i had an issue with wrist connecd to the thumb on right hand. I feel something on them left hand but not painfull really. My inhand is warm from time to time. I feel great when doing sport. It is as if the clouds are gone. I will XXXXXXX the doc this week but was thinking why noone did fr so far. Also, i do not know if you guys can do a diagnostics based on one factor only, ????? Can you?

I recall last year i had some pain on the right wrist after the marwaton i run in paris. But was coming and going....

The ears and the discharge are also started back in march. i have heavy shocks of anxiety since no diagnose was done so far and did so many tests.... Ony now i have some clue.

Do you have something elese in mind that can explain the symptoms and the rf 43, did it again friday is 38. My crp, sed rate are ok for months. What is moving is the neutrophill which my hematologist say is ok.

Since a week, i have some pain in the anckes and warm... This is very in line with what ou say.
And lastly, if it is ra. Should i be scarEd? I am 30... And do not want to die young.
Can i fight this without this scary drugs ? Is there alternatives treatmens?
And really last point, i gained 10 kg in 3 monts....is thisin line withra?

I have huge apietite
My joints are not swollon, well at least not vsable.

the is only one place that is specific to hurt all the time (right thumb), the rest is here and there and it comes and goes. I feel something similar on the left thumb but it is way not as specific as the right.

Sometimes I feel anckles create a sound like how to say, when bowel is moving kind of feeling. Huts but comes and goes... not in one place all the time.

In terms of hands, only visible thing is that I have skin dropping like when you miss vitamins... thats all.

please kindly advice on the points above
Hla b 27, lupus test both negative.
Thanks for your advice.
A.

 
 
Answered by Dr. Praveen Jadhav 45 hours later
If it is RA, it is definitely treatable and you should not be scared of anything, including the drugs.

Let the rheumatologist examine you and decide if there is swelling or not. If there is, it will help in diagnosis.

It is good that HLA and lupus tests are negative
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Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 25 minutes later
Hi thanks. I just did ultrasound and it is negative. So I am loss
Could this be something else??? I feel heat all over the body not only joints
It is inears and neck....crazy stuff could this be RA?

hi again,

I was just off to the psephologist and his conclusion is that it is Psychosomatic problem. Gave me Vit D, some kind of mental drug as well as told me to
take pain killers; on the RF he told me it can be related to past viral infection ( I had one in Feb).

He said, PETCT and Ultrasound does not show any evidence of inflammation as well as CRP and SED.
so, now I am not sure if I need any further tests or not. I have these crazy symptoms for months now and no one can tell me whats wrong.....

any ideas ? SHould double check wtith oth Reumatholog ? Should I do more tests ?
thanks for the help.
 
 
Answered by Dr. Praveen Jadhav 23 hours later
Dont do any further tests. If the psychiatrist has told you about a problem and advised you any medications, just trust him and follow his advise. Dont take multiple opinions.
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Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 1 hour later
Hi,
I am really struggeling and have no clear diagnosis. You mentioned it is critical to
Get it if it is the case early, i mean the ra.

Do you have any advice at least what i should do, instead of waiting and taking pain killers.... For example a diet or something thatcan help these joints stop cracking and hurting. Is it true that if my sed and crp,are good this is not Ra?

Thanks a lot. If you could please help me with some more explanataions. I can pay you more, even i can fly to the states if needed.

Thansk
 
 
Answered by Dr. Praveen Jadhav 22 hours later
Normal sed rate and crp reduces the chances of it being RA. There is no speciifc diet to reduce the pain in RA. Since the wait for your rheumatologist is only a few days away, please be patient and take his opinion.
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Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 2 days later
Hi Again,
hope you had a good weekend. I wanted to summarize the situation and ask for your opinion.

1. I did three (excl. your ) Rheumatologist consultation:
a) first told me that there is nothing, gave me Vitamin D and anxiety drug.
b) second told me that all these problems could be due to Uric Acid and gave me Zyloric to drink for long time. his opinion is that it is acid driven although in the past the levels were below 7 he said 5.6, 5.6 were still high.
c) was an online just an opinion which mentioned Splodetis Arthritis but by B27 is negative.
2. My symptoms are just like come and go. The only certain ones are the right wrist, connected to the thumb pain, even when I touch. (Echography shows no inflamation). I have these hot feeling which come and go on the back and in the ears. Even in the ear i feel( and this is coming and going long time) like a small painful feeling like a XXXXXXX baloon which at one point brakes... and acid is there.

eyes are still good and bad within the day ...vary.

since, you are the first to cocntact on this matter, I wanted to ask you should I
> drink the drug for Uric Acid ? (are there side effects, or I try homeopathioc drugs ?
> any idea on my problems (given CRP, SED and the others...)

I need to know what to do...since there is no clear path to follow.
In fact, could I have all these issues due to Uric Acid ? It was 5.6, then 5.7 back in April and May. The doc say it is still high... so I am lost.
lastly, can you offer me a diet to follow to see if I can improve ?
please help
XXXXXX

 
 
Answered by Dr. Praveen Jadhav 23 hours later
I am sorry I am late, replying from the airport.

Since you had consulted an expert Rheumatologist I would agree with their ability and opinion. Hope you agree that a physical consultation has greater edge than online opinions. ESR and CRP are normal that reduces the chances of being Rheumatoid arthritis. Since it's a brief episode it can be due to acute rise in uric acid levels. Both the values you mentioned are within normal limits.

All dark colored vegetables and fruits are good, i mean the ripened ones. They are antioxidants. I agree that your anxiety is bypassing your overall wellness. You are more anxious than the actual problem. Start relaxing and give yourself some time to reset.

I am flying for a sympo I doubt an easy access to internet.

All the best.

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Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 1 hour later
Tanks a lot. What I need to know is if this Uric Acid can cause these symptoms...
he say that even 5.9 is high and should be low (ref 5.9 I had in april where I had similar symptoms).

I guess, I am trying to understand if this acid can be the sole cause of this stuff.
what is the significance of RF in this case?
lastly, do you think this can be result of the scans I did, I read lots of bad stuff on the internet and I am scared now. My count is about 20msv for the tests.I have also attached an image on I hope not a noudle on my thum.

It comes and goes, and it is hardly visable and red. Not firm. Sometimes is red when I touch it. I recall I have that for long time, maybe years. Not growing as of now..

can you review and let me know your opinion? REumato did not notice this I trust
 
 
Answered by Dr. Praveen Jadhav 8 hours later
Hi,
Thanks for writing back,
I dont think a high uric acid will cause symptoms like these. Also radiation cannot lead to these symptoms.
about the swelling in your thumb, I dont think its related to this. It could be a lipoma or an allergy or maybe a minor trauma. I dont think you need to worry about this.
Rheumatoid arthritis does not cause symptoms like these. I dont think you need to worry about the rheumatoid factor.
Hope this helps
Regards
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Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 3 hours later
Thanks sir.

back to the basic question whats wrong with me ? When you say RA does not cause symptoms like these, what do you mean?? Why my RF is up ? What can be my problem ? I am trying to keep a balanced diet now and take this drug for the uric acid. To you, do I have RA or not ? If it is in an early stage I'd liketo prevent it. I am scared if it can be cancer .. I did also some scans so radiation is also a ig concern for me...What do you think ?

Should I take the Zyloric ?
I mean I don't want to have side effects if not necessarily ?

thanks for the advice.
XXXXXX
 
 
Answered by Dr. Praveen Jadhav 17 hours later
Got some time back. I went back to your main query again. I recollected all the discussion we had yet, yes few reports and pictures as well.

All the symptoms described seem non significant for me as a Rheumatologist point of view. With your physical consults with Rheumatologist I can be pretty stern on this point. RA is very unlikely. I may not be right person to say for the other complaints that you make.

As far as I know you just need time to heal. Mind and body work together, is it not? Even if body is healed the mind still tries to find some faults. I would not comment too much. You just need some counselling from a physical doctor and give a lot of assurance about your physical health.

You may stop Zyloric as well after speaking the one Rheumatologist who prescribed you. Do not worry not much side effects.

I am sorry I may not be available for your follow ups as I am travelling the next two weeks. Please do not mind. I sincerely advice few counseling sessions before you call me back here.

All the best, I know you will even get better soon.
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Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 6 minutes later
Hi thanks. DO you think I have ignificant risk of cancer to the imaging I did ?

thanks and I will see what to do next.
XXXXXX
 
 
Answered by Dr. Praveen Jadhav 25 minutes later
good you called immediately, unlikely to be significant risk for cancer.

Good luck.
Above answer was peer-reviewed by
 
Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 19 hours later
Hi, thanks.
I am in fact doing the therapist. In fact, I attached (newXXX) two more images, I have those for long time as well but only now I pay attentin to them. It is like a dead skin on the back of the achilles. is this RA?

thanks and please let me know. I really do not know what to do.

thanks

ps I have them in both legs, more visible on the right.
ps 2. and the eyes ...like the eye lids are spicy, like you have lemon in them or so.,.. it comes and goes... the whole thing, even the chills come and go.


 
 
Answered by Dr. Praveen Jadhav 41 hours later
Hi,
The dead skin on the back of achilles is not rheumatoid arthritis. The constant irritation in the eyes can be due to dry eye. You should be washing your eyes frequently and can try using artificial tear drops
Hope that helps
Regards
Above answer was peer-reviewed by
 
Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 3 hours later
Thanks. What i do not undestand is why i ahve these problems.
The jointa in the morning are ok, but as the day goes along start issues.

Now both thumbs feel pain connecting the wrist. And all is cracking....


It is reallynhard for me... I tried drops no effect. I recall eyes were better when i was taking antibiotics....
In fact have you seen the images??? Just to confirm that this is not due to ra?
 
 
Answered by Dr. Praveen Jadhav 24 hours later
Hi,

Diseases like RA and other rheumatological diseases have multiple factors behind them like genetic and immunological basis. They are known for remissions and recurrences throughout.

You can at least start yourself on the basic DMARD drugs and look for improvement.

I have seen the images uploaded by you. Please discuss about this again with your Rheumatologist.

Hope this helps.

Regards,
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Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 3 hours later
Hi do you thinkd thr achiles thing is RA!? So according to you di I have RA. Or not??
I am confused
 
 
Answered by Dr. Praveen Jadhav 20 hours later
Hi,
There are several things that need to be clarified here. First , the thickened skin on the achilles is not due to rheumatoid arthritis. Secondly, all your other symptoms are suggestive of rheumatoid arthritis. Treatment needs to be started under the supervision of a rheumatologist.
I hope I have addressed your queries.
Regards
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Follow-up: Burning eyes, joint pain, chills, warm ankles, ear discharge, feeling hot on back. Can you help me? 7 minutes later
Hi there,

Sir, your first diagnosis was RA, then you told me the symptoms are not related to RA, and now we are back to RA. Lets try to put things in order if you agree:

Clinical: joints pain here and there, eyes feel spicy, I feel tired but have energy, cracking all over, sleeping a lot, specific pain where the thumb connects to the wrist. Chills sometimes, beep in the right ear with acid diss-charge.

Blood: all in range but uric acid (7.9), Vit D (26), and RF = (38). CPI, SED negative. anti CCP =1 out of 10 min.
No inflammation according to the blood tests and pet scan.

I see the DMARDS are very XXXXXXX with side effects. So, I would like to know if there is an alternative...? I am too young to get chemicalised ... scared to death.

thakns and please let me know your final conclusion as we started with RA, then was not RA and now is RA again. Thanks a lot sir.
Links on Imaging:
CT Abd
WWW.WWWW.WW
PETCT
WWW.WWWW.WW
 
 
Answered by Dr. Praveen Jadhav 2 hours later
Let me clarify my thoughts and end this discussion after this post.

The odds it being RA is low i.e RA would be in the lower order in the list of differentials. We should look into alternatives. I would not be able to help with alternatives with complex history adding each time. All your labs & images are non specific and do not point to anything specific to probe further. All said it is really difficult to pin point any diagnosis on this forum. Remember your Rheumatologist have a difficult time to understand the exact clinical scenairo.

If I were your treating doctor I would use all my other avenues like anxiety medication, physical therapy and counseling for atleast 3 -6 months. I would not jump into prescription of DMRAD's. It would not be good to put on high dose DMRAD's at this moment.

At last this kind of platform should add value to your treating doctor's decision and treatment but should not create confusion. This is not a platform for diagnosis.


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