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Exhausted,body pain,epstein barr,extreme pain in left hip,groin,knee,cortisone injection,physical therapy

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Internal Medicine Specialist
Practicing since : 1998
Answered : 1579 Questions
I am a52 yr old female.I started exercising regularly in Sept of last yr and was up to 5 miles on the treadmill by XXXXXXX I have always been active so this was not a huge jump for me. By the end of Feb I was not even able to go 5 min on the treadmill. I suffered from exhaustion and all over body pain. I was diagnosed with epstein barr but I have had extreme pain in my left hip,groin, and knee ever since then. I have had xrays and they show no arthritis. I have had a cortisone shot in the knee and it didn't help. I have been going to physical therapy for 4 wks and there is barely any relief at all. Any suggestions?
Posted Tue, 1 May 2012 in Bones, Muscles and Joints
Answered by Dr. Jasvinder Singh 2 hours later

Thanks for posting your query. One important point to be noted in your history is that you are having pain in left hip, knee and groin and hence the left upper limb is effected. Earlier you were having body pains and exhaustion as well.

Keeping these points in view, few possibilities are important and need to be ruled out in your case. These are:

1)     The first possibility is of polymyalgia rheumatica which is an inflammatory disorder involving pain and stiffness in the shoulder or hips and is found in people over 50 years of age.

2)     Second possibility is of arthritis of the hip joint and knee joint. X-rays are not a specific test for diagnosing arthritis and you need blood work and MRI scan of the joints to rule it out.

3) Third possibility is of a spinal cause like spinal stenosis or degeneration disc which are causing nerve compression and hence pain in hip, groin and knees. You need to get a MRI lumbar spine done to rule out this possibility.

Complete physical examination along with investigations like ESR blood, Rheumatoid factor, creatine kinase, electromyography, MRI joints and spine and muscle biopsy may be needed to make a diagnosis. I advise you to get these tests done after consulting an orthopedician.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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