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Suggest Treatment For Severe Joints Pain
Question: I am 66 years old Two weeks ago after nightly Macrobid had been dc;d for 2 weeks I developed C,Diff
diagnosed by symptoms and stool culture. I was not hospitalizes but in hindsite should have been. I week
later I have very severe joint pain. I was given a dose pack of Solumedrol which has given only some relief.
I still can hardly move due to pain. Past history include past renal disease after an untoward event 10 yrs
ago where I had multi system failure. I cannot get an appointment with a Rhematologist until XXXXXXX A long time to put up with these symptom
diagnosed by symptoms and stool culture. I was not hospitalizes but in hindsite should have been. I week
later I have very severe joint pain. I was given a dose pack of Solumedrol which has given only some relief.
I still can hardly move due to pain. Past history include past renal disease after an untoward event 10 yrs
ago where I had multi system failure. I cannot get an appointment with a Rhematologist until XXXXXXX A long time to put up with these symptom
Brief Answer:
Reactive arthritis
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well, the sort of symptoms you are having mostly fits in with reactive arthritis. It is a form of arthritis which occurs as a reaction to certain bacterial infection occurring elsewhere in the body. Clostridium Difficile is a very common organism to cause this sort of arthritis. I would like to ask you a few more questions, to help determine the severity of this kind of arthritis:
1. Which are the joints involved at present??
2. DO you experience any backache or neck pain?
3. Any symptoms of burning in the urine?
4. Any history of redness of the eyes or burning sensation in the eyes?
5. Any other anti inflammatory medications which you are taking?
Reactive arthritis is a self limiting condition and tends to go off after 2-3 weeks. Very few cases are known to persist for longer duration. Do let me know these queries. Will advise you a few tests just to be sure it is not some other form of arthritis and if any investigations are needed. XXXXXXX is a pretty long time. Hopefully you would have recovered by then.
Await your reply
REgards
DR Naval
Reactive arthritis
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well, the sort of symptoms you are having mostly fits in with reactive arthritis. It is a form of arthritis which occurs as a reaction to certain bacterial infection occurring elsewhere in the body. Clostridium Difficile is a very common organism to cause this sort of arthritis. I would like to ask you a few more questions, to help determine the severity of this kind of arthritis:
1. Which are the joints involved at present??
2. DO you experience any backache or neck pain?
3. Any symptoms of burning in the urine?
4. Any history of redness of the eyes or burning sensation in the eyes?
5. Any other anti inflammatory medications which you are taking?
Reactive arthritis is a self limiting condition and tends to go off after 2-3 weeks. Very few cases are known to persist for longer duration. Do let me know these queries. Will advise you a few tests just to be sure it is not some other form of arthritis and if any investigations are needed. XXXXXXX is a pretty long time. Hopefully you would have recovered by then.
Await your reply
REgards
DR Naval
Above answer was peer-reviewed by :
Dr. Shanthi.E
To answer your questions: The joints effected are my back ( I have kyphosis,and
scoliosis), my hands, my fingers, severe in both elbows, both knees, and severe
in both feet.I do have burning with urination but my urine is clear without odor.
Another history that I have is Anesthesia Dolorosa developed after an alcohol
injection to the left trigeminal ganglion in 2003. This is an ongoing problem with pain in my left eye. I am only on Prednisone 10mg which is starting to make my
joints be better. I can use no other inflammatory drug, My Neuroligist will not allow it. He would probably be angry with the Prednisone use!! It just hit me fast and hard. I try to stay active, though retired. I am a CRNA and since my primary care physician is 50 miles away we do a lot of communication by phone
Thank-you for letting me know the usual duration and that this happens often.
scoliosis), my hands, my fingers, severe in both elbows, both knees, and severe
in both feet.I do have burning with urination but my urine is clear without odor.
Another history that I have is Anesthesia Dolorosa developed after an alcohol
injection to the left trigeminal ganglion in 2003. This is an ongoing problem with pain in my left eye. I am only on Prednisone 10mg which is starting to make my
joints be better. I can use no other inflammatory drug, My Neuroligist will not allow it. He would probably be angry with the Prednisone use!! It just hit me fast and hard. I try to stay active, though retired. I am a CRNA and since my primary care physician is 50 miles away we do a lot of communication by phone
Thank-you for letting me know the usual duration and that this happens often.
Brief Answer:
Reactive Arthritis
Detailed Answer:
Good evening
Well it is good that it is improving. But i would recommend you to do a few tests just to be sure we are not dealing with arthritis for which long term medication has to be given. Prednisolone will reduce the joint pains and inflammation, but considering side effects of the drug on long term basis, we need to be careful with it.
I would recommend you to do ESR, CRP, Rheumatoid Factor, Anti CCP antibody and HLA B 27(PCR). These are the few tests which will help us prognositicate the disease. In Reactive Arthritis, we normally dont expect so many joint involved. So just to be sure it is not some other form of arthritis, I would recommend these tests.
Till then you can continue prednisolone and after 2 weeks dosage try to taper it.
Do let me know for more queries
Would be happy to help out
REgards
Dr Naval
Reactive Arthritis
Detailed Answer:
Good evening
Well it is good that it is improving. But i would recommend you to do a few tests just to be sure we are not dealing with arthritis for which long term medication has to be given. Prednisolone will reduce the joint pains and inflammation, but considering side effects of the drug on long term basis, we need to be careful with it.
I would recommend you to do ESR, CRP, Rheumatoid Factor, Anti CCP antibody and HLA B 27(PCR). These are the few tests which will help us prognositicate the disease. In Reactive Arthritis, we normally dont expect so many joint involved. So just to be sure it is not some other form of arthritis, I would recommend these tests.
Till then you can continue prednisolone and after 2 weeks dosage try to taper it.
Do let me know for more queries
Would be happy to help out
REgards
Dr Naval
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Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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