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Diagnosed to have osteoarthritis of hip. Has knee pain and ankle swelling. Diabetic and hypothyroid. Reason for high CRP?

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Jan 2013
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Hi,
My mom has positive RA factor and CRP is 8.2.
She was diagnosed to have osteoarthritis of hip. She has pain on her left knee and recently had ankle swelling for nearly 10 days. She is diabetic, has hypothyroid and also diagnosed to have osteoporosis.

1) Is it rheumatoid arthritis or any other type of arthritis?
2) Also, Please let us know the reason for her high CRP
3) Uric acid was 4.9 and urea at 36.2. Could it be gout?
Posted Fri, 31 May 2013 in Osteoporosis
 
 
Answered by Dr. Mayank Bhargava 1 hour later
Hi XXXXXX
Welcome to XXXXXXX forum.

Let me explain your query one by one.

CRP and ESR are non specific investigations and high values generally indicates presence of active disease whether osteoarthritis or rheumatoid arthritis.
It could also be elevated in other organ associated disease such as ischemic heart disease, connective tissue disorder.

RA factor could be falsely positive or could also be a feature of rheumatoid arthritis.

Rheumatoid arthritis could be associated with positive and negative RA factor and for confirmation, your mother should go for Anti-CCP antibodies.

Rheumatoid arthritis is associated with pain in proximal interphalyngeal joint in hand, wrist ache back ache and neck pain while Osteoarthritis is associated with pain in knee, hip and distal interphalyngeal joint in hand.

Gout is associated with raised serum uric acid level (> 6.0 mg%) and is associated with pain in joint of big toe in foot.
Although few literature also favors that gout or joint ache could also be associated with normal serum uric acid.

You should consult with XXXXXXX medicine specialist/ orthopedic surgeon and should go for thorough check up.
She should also go for erythrocyte sedimentation rate (ESR), Anti-CCP antibodies.
Diagnosis of rheumatoid arthritis could be confirmed with positive Anti-CCP antibodies.

Treatment depends on exact diagnosis.
Meanwhile, she should take Glucosamine with diacerein, along with gastroprotective NSAIDs.
You should also consult with physiotherapist for assistance in joint movements.

Hope that helps.
Let me know your other query.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
 
Follow-up: Diagnosed to have osteoarthritis of hip. Has knee pain and ankle swelling. Diabetic and hypothyroid. Reason for high CRP? 8 hours later
Could elevated CRP be related to her hypothyroidism (she takes 25 mcg of the medicine, every morning)?

What is your inference with the current RA factor and CRP? Similarly uric acid and CRP?

ECG taken 2-3 months was also normal. Her BP is also normal. If you could zero in exactly for her, it will help a lot. ESR (2 hr stuff) was 35
 
 
Answered by Dr. Mayank Bhargava 2 hours later
Hi,
CRP could also be elevated in hypothyroidism as most of the cases are due to Hashimoto's thyroiditis which is also an inflammation.
Presently CRP is raised and RA factor is within normal limits.
Still she should go for Anti-CCP antibodies to rule out Rheumatoid arthritis.
Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
 
Follow-up: Diagnosed to have osteoarthritis of hip. Has knee pain and ankle swelling. Diabetic and hypothyroid. Reason for high CRP? 23 minutes later
Problem is zeroing in on exact problem? Whether it is due to arthritis, thyroid, kidney or heart? I had shared medical check results? Could you help or suggest which specialist to go for?
 
 
Answered by Dr. Mayank Bhargava 18 minutes later
Hi,
I am not able to understand meaning of "If you could zero in exactly for her".
As it is non specific investigations, its very difficult to comment that which disease is causing high CRP.
You should consult with XXXXXXX medicine specialist/ orthopedic surgeon for expert opinion.
Sincerely,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
 
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