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Have tennis elbow. Knee surgery done. Have high ASO. On penidure injection. Any suggestion?

DOCTOR OF THE MONTH - Sep 2012
Sep 2012
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General & Family Physician
Practicing since : 2008
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I underwent a knee surgery recently. I have a high ASO of 704 and on penidure injection 12 since 4 months, high ASO symptoms were noticed about 20 years but was untreated. How long I should be on penidure injection and is high ASO has contributed OA? I too have a tennis elbow for both of my hand.
Posted Mon, 13 May 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. Das Arindam 2 hours later
Hello,

Thank you for posting a query.

Look, you did not give the full history. 20 years ago, you were found to have high ASO titer but left untreated. Now, you have a knee surgery and high ASO titer.

What was the cause behind that?

Did you have any joint pain which changes its site regularly?

Do you have any cardiological problems like palpitation, breathlessness, weakness?

All these points are very important. Because the duration of the treatment with penicillin depends on these.

Most probably, your treating doctor has found some suspicious findings (apart from arthritis and high ASO titer) about rheumatic fever. Because high ASO titer is associated with this disease.

But, no doctor can help you online. Because, this disease is diagnosed on the basis of clinical examination. There are some criteria to stamp this disease, which consist of some very important clinical findings. Most importantly, ASO titer is only a supportive criteria.

So, it would be better to consult with your treating doctor about it. That is the only way. I think you can understand the problem.

But, for your information, penicillin injection should be given for years. As I have told, the exact duration depends on the clinical condition.

Yes, the arthralgia you have described may be caused by this disease. But, as I have told you previously, the final diagnosis depends on your treating doctor.

Hope this information suffices. Let me know, if you have any more question.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have tennis elbow. Knee surgery done. Have high ASO. On penidure injection. Any suggestion? 21 minutes later
HI DOCTOR

20 YEARS AGO I HAD ASO SYMPTOMS BUT NOT TESTED AND TREATED. 4 MONTHS AGO I TESTED FOR ASO & FOUND 704. RIGHT KNEE STARTED PAINING 6 YEARS AGO AND NOW DIAGNOSED FOR OA AND SURGERY DONE. LEFT KNEE ALSO STARTED PAINING LITTLE WHILE CLIMBING STEPS ABOUT 2 MONTHS AGO. JOINT PAIN IS NOT CHANGING REGULARLY, BUT ADDED TENNIS ELBOW TO BOTH HANDS ABOUT 6 MONTHS AGO. I DO NOT HAVE PALPITATION, BREATHLESSNESS BUT FEELING WEAKNESS.

I HOPE THE ABOVE INPUTS ARE BIT SUFFICIENT TO GIVE ME AN ADVISE.

I AM BIT CONFUSED TO WHOM I HAVE TO CONSULT WHETHER WITH ARTHOPEDIC
OR GENERAL MEDICINE. KINDLY ADVISE.
 
 
Answered by Dr. Das Arindam 2 hours later
Hello,

Thank you for writing back.

From your history, your problem with joint pain does not sounds like a rheumatic disease. Because, osteoarthritis and rheumatic disease are different.

Your description is not enough to tell the exact duration. Because, for that, i have to examine you clinically. secondly, an ECG is needed. Thirdly, an Echo cardiogram is needed.

If everything is fine, then injection should be continued for 5 years followed by oral antibiotic of penicillin group. In some cases, low dose oral antibiotic is necessary for many years after completion of injection. The duration depends upon the response of the patient towards antibiotic.

For exact duration, you have to consult with your treating doctor.

It would be better to consult with a cardiologist for this problem. Because, you need to be evaluated for presence of any cardiovascular abnormality, irrespective of presence or absence of any symptoms. You can also consult an XXXXXXX medicine in person for this problem, if you want.

Hope, you have your answers.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have tennis elbow. Knee surgery done. Have high ASO. On penidure injection. Any suggestion? 39 hours later
HI DOCTOR

THANKS FOR YOUR ADVISE. I HAVE ATTACHED ECHO AND ECG REPORTS WHICH WERE DONE ONE MONTH AGO DURING KNEE SURGERY.

I SHALL CONSULT DOCTOR AS PER YOUR ADVISE IN PERSON FOR CLINICAL EXAMINATION.

I HAD A SKIN ITCHING FOR 20 YEARS & SHOWED TO THE EXPERTS BUT DID NOT CURE, EVER SINCE I STARTED PENIDURE INJECTION IT HAS REDUCED BUT NOT FULLY GONE. I AM ONLY GUESSING THAT THIS IS ONE OF THE SYSMPTOM OF HIGH ASO (20 YEARS AGO).

KINDLY GIVE YOUR OPINION AFTER REVIEWING TEST REPORTS.

REGARDS
XXXXXXX XXXXXXX
 
 
Answered by Dr. Das Arindam 5 hours later
Hello,

Thank you for writing back.

Look, Your ECG and echo are all within normal limit.

So, there is no cardiological abnormality. But, still you should consult with an XXXXXXX medicine specialist.

Generally, in this situation, penidure is given for 5 years.

You should consult with your treating doctor or XXXXXXX medicine specalist for exact duration.

Hope, you have your answers.

Regards.
Above answer was peer-reviewed by
 
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