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Swelling in knee and pain. Taken drugs. What does ESR report suggest? Medication?

Sir, My daughter aged 20 yrs old is suffering from pain with swelling only in Knee from some days . esr is 78mm/h and other report is normal. A Physician suggested antibiotics (Amoxycilin 500mg tablet 5 time a day for 5 days) and pain killer drugs for 5 days. After within 5 days no pain and reduced 90% swelling and cure stopped. Now she is suffering from small pox for 6 days and taking medicine of this disease. along with small pox now again from today morning ( India date 13.10.2012) starting pain and swelling in Knee. 5yrs ago she was suffering from pain with swelling in Knee. Sir, We observe that both the time due to taking very low diet about one month caused the pain and swelling in Knee and esr report is 76 to 78 mm/h. Please suggest type of medicine and food suplimants, other helpful remedy.
Asked On : Tue, 16 Oct 2012
Answers:  2 Views:  94
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  Anonymous's Response
Firstly no one can have small pox as this is eradicated so you must have meant chicken pox!
ESR can be raised for several reasons, such as anemia, infections, inflammation but most importantly improper handling of blood specimen. But as she has inflammation clinically, the result cannot be ignored.
CRP is a better test to know the type of infection along with CBC, RhF (or CCP) and ANA screen if there are other smptoms of CTD.
XRay of knee is recommended to exclude bony pathology.
NSIADs wih PPIs are recommended. Food supplements unhelpful unless there is anaemia of chronic disease.
Answered: Thu, 18 Oct 2012
Pulmonologist Dr. Arnab Maji's  Response
Thanks for your query
Your daughter's ESr is high which indicates that knee swelling is probably due to infectious etiology. Tuberculosis of knee joint particularly causes high ESR values. Again in collagen vascular diseases ESR gets high value. In this respect i ll suggest you to consult an orthopedic surgeon and if possible fluid can be aspirated from that swollen joint and send that fluid for acid-fast bacilli staining and culture. Another two possibilities are rheumatic fever and rheumatoid arthritis. Just go for laboratory testing like ASO titre in the serum and RA factor and Anti-CCP estimation in the serum. Meanwhile do continue the antibiotics for 2 weeks. I think by all these your doctor will get clue about the diagnosis.
Thank you.
Answered: Wed, 17 Oct 2012
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