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Having pain, inflammation, hotness and swelling in ankle after taking Kenalog and Xylocaine injection in arthuritic knee. Cure?

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Kenalog injection in knee XXXXXXX 19, 2013, Two weeks later left anlkle became inflamed, hot, and swollen. Painful to walk on. One week later left shoulder became inflamed, hot and unable to lift. Went to Dr. had bloodwork done, everything came back fine except Inflamation level at 76, when normal is 17. More bloodwork to eliminate RA, gout, other inflammatory diseases. Last month toe and sole of right foot b ecame swollen, red, hot and inflamed. Dr. has eliminated any other factors. Only invasive procedure was injection of Kenalog and Xylocaine in arthuritic knee. Help.
Posted Mon, 8 Jul 2013 in Bones, Muscles and Joints
Answered by Dr. Luchuo Engelbert Bain 3 hours later
Hi and thanks for the query,

I think the tests asked by your doctor were effectively in the right direction. The erythrocyte sedimentation rate at 76 is pretty high. This is a pauci/polyarthritis you are presenting with for sure and deserves a very careful evaluation.

Negativity of Rheumatoid factor does not however exclude totally the possibility of rheumatoid arthritis. It would be important to get a proper rheumatological assessment. Other rheumatologic conditions like systemic lupus erythematosus, and mixed connective tissue disease could behave as such. A complete blood count is important under these circumstances. A septic multi arthritis must also be ruled out systematically.

I do not think continues injection of Triamcinolone (Kenalog) without an exact diagnosis is appropriate. This is symptomatic treatment and it also carries its side effects.

My suggestion is booking an appointment with a rheumatologist for a complete rheumatological work up. Back u X rays of attained joints should also be done. Ruling out a septic multiarthritis should be borne in mind. It is not unusual to have rheumatoid arthritis with negative blood tests for the Immunoglobulin usually tested for in this disease.

Thanks and hope this helps. feel free asking further questions if need be. best regards,

Bain LE, MD.
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