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Having joint and muscle pain, hip and low back pain. Given injection in SI join. On celebrex and Hydroxychloroquin. What can be done?

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General & Family Physician
Practicing since : 2009
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I have been having joint & muscle pain for about 30 years now, recently , since Sept of 2012 I started having right hip pain and extreme lower back pain, was given injection in right hip in January, helped for about 3 weeks, pain in buttocks and lower back continued to increase,was given an injection in SI joint 2 weeks, was about 90% better, starting to ache again. My question is this and until last week never thought there might be a connection, everytime the pain first occurs in an acute stage (pain level between 6-8) about a month before I will run fevers for about 5 days between 101- 102 degrees, with severe chills, will always start rising between 10 am and 12 noon and somewhere in the wee hours 3am - 4am it will break. is there any possible connection to the joint pain I've never thought to tell my rheumatologist. Usually as I stated before about a month later I will have severe pain for about 1 week to a month, then it just goes into this chronic pain that slowly diminishes over time. I am on celebrex twice a day and 200mg of the Hydroxychloroquin
Posted Thu, 20 Jun 2013 in Lupus
Answered by Dr. Luchuo Engelbert Bain 2 hours later
Hi and thanks for the query,

Its good already that you are being followed up by a rheumatologist for you have a rheumatologic condition for sure, and the drugs you are taking are very appropriate. It might actually be important to have a keener look into this new onset pain. It s important to actually elucidate the cause of the fever and the pain. Other causes of back pain, not of rheumatologic origin should be checked for. Pott's Disease or spinal Tuberculosis is a common disease that can present itself as such. A spinal malignancy also should be checked.

A complete blood count is very necessary to check for infectious markers, platelet count and hemoglobin levels, which could actually orient further testing. An erythrocyte sedimentation rate, a spinal X XXXXXXX and MRI are of vital importance to check for indications of a spinal TB, compression, tumour or any mechanical lesions in the spine.

It should however not be excluded that rheumatologic diseases on their own could be characterized by fever. In cases of systemic lupus erythematosus, polymyalgia rheumatica, fever and chills are seen many times.

A reevaluation by your rheumatologist, to exclude on infectious processes that could cause back pain, spinal compression and fever like Spinal TB, spinal Tumours and inappropriately managed rheumatologic conditions that could be at the origin of these symptoms. appropriate clinical evaluation, laboratory and Radiologic examinations should be sufficient to make or to orient a proper diagnosis and subsequent management.

Thanks and hope this helps. Do not hesitate asking further questions if need be.
I would be honored to contribute in my own way to your well being.

Best regards,
Luchuo, MD.

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