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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Pain And Swelling In The Hands And Legs?

I have had pain in my ankles feet and hands and swelling. My blood work showed sed rate was 32 and hematocrit was 34 tsh is 4.11. Ra factor was negative but there is definite inflammation and pain. I saw an orthopedic but they didn t think anything if the blood work
Mon, 15 Sep 2014
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  User's Response
Hi, thank you for posting your concern here. You are definitely symptomatic with a high ESR, lower normal hematocrit, and high borderline TSH. My recommendations will be-
1. Tab Paracetamol 500mg (dose may be modified depending upon your weight and age) S.O.S (min. 6hr interval)
2. Good hydration
3. Compete blood count, serum uric acid
4. XRay of the affected joint
5. Further workup may be done depending upon the results. You may also need ANA and related tests done. But, first have these tests done.
6. Diet, specifically calorie modification for 3 months. Avoid empty calories, high fat diet and do exercise (which doesn't aggravate your pain) and get repeat TSH after 3 months.
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Orthopaedic Surgeon, Joint Replacement,  Dr. Dr. Naveen Kumar Sharma's  Response
I think you are having seronegative arthritis. In this condition there is joint pain and stiffness and patient has difficulty in movements but Ra factor is negative, so it can not be named as Rheumatoid arthritis.
I would suggest you to get one more test which is called as Anti CCp antibody test. This test suggest that you are having inflammatory arthritis and anti ccp test is more sensitive and specific test.
I would recommend you to show it to rheumatologist. He might want to start HCQ, SAAZ, and Methotrexate . If pain is very severe you might need steroids also for short time. Treatment will be for few months and after that we can reduce drugs. Avoid cold temperature . Never stop drugs in between the course.
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What Causes Pain And Swelling In The Hands And Legs?

Hi, thank you for posting your concern here. You are definitely symptomatic with a high ESR, lower normal hematocrit, and high borderline TSH. My recommendations will be- 1. Tab Paracetamol 500mg (dose may be modified depending upon your weight and age) S.O.S (min. 6hr interval) 2. Good hydration 3. Compete blood count, serum uric acid 4. XRay of the affected joint 5. Further workup may be done depending upon the results. You may also need ANA and related tests done. But, first have these tests done. 6. Diet, specifically calorie modification for 3 months. Avoid empty calories, high fat diet and do exercise (which doesn t aggravate your pain) and get repeat TSH after 3 months.