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Having Pain In Fingers Joint, Fever, Loss Of Appetite And Red Patches On Palm. Any Advice?

Posted on Fri, 16 Nov 2012

Question: Dr. XXXXXXX XXXXXXX Orthopaedic Surgeon from Healthcare Magic was answering to my below question where after reading my Question and studying my reports assumes that I might be having Chicken Chikungunya Chronic arthritis.

while searching internet, I came across your article on "Post-Chikungunya Chronic Arthritis – Our Experience with DMARDs Over Two Year Follow Up" where I read that this is curable by using DMARD.

below is the question I posted for which Dr XXXXXXX was answering.

the problem I am describing below does exist from many years and is related to joints of my fingers as well as finger joints of my feet. what I have observed that when I get this pain, the particular joint will swell.

if the pain is in my hand fingers, it will be hard for me to bend it or hold something with and if its in the joint of the feet fingers, its hard for me to walk.

the symptoms I have observed during this pain is : 1. Fever 2. uneasiness 3. low apettite. 4. red blood clot kind of patches on the palms and below the feet (4. not necessary always )

I have to take pain releivers like Dolo 650 or any other Fever related tablets to overcome the situation. usually the pain stays for 3-4 days and it might move into other fingers too.

I have the below diagnostics reports if you would like to have

L.profile + VLDL

Blood for C reactive Proteins

Complete Blood Picture

Blood for ESR

awaiting early response please

thanks

XXXXXXX

Answered by Dr. Divya Agarwal (10 hours later)

Hi XXXXXXX,
Thanks for writing to us.
I have gone through your case.
I need a few clarifications.
Firstly you describe that you have been suffering from this problem for many years. So do you mean that you suffered from Chikungunya many years ago.
Secondly some of your reports opened but the reports in pdf 2 and 3 were blank. So I need to know your ESR and CRP and also if you have got tested for rheumatoid factor.

From your description of your arthritis, you seem to be having a condition called palindromic rheumatism.
This is a condition where a single joint usually swells up and hurts , generally lasts for a few days and then subsides on its own or with pain killers.
It generally does not leave any sequelae which mean that there is no damage or deformity to joints.
The treatment for the same is with certain medicines like hydroxychloroquine.
These can prevent further attacks from occurring.
I hope I have been helpful.

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Divya Agarwal (10 hours later)

Hi XXXXXXX
thanks for your response
1.Answering your first question, I am exactly not sure about the date but it might be in the year 2006 or 2007.

2.I have attached the reports now(let me know if any problems opening them), do you want me to go through the test named: Rheumatoid factor ?

3. as per your assumption I might be suffering from palindromic rheumatism (you might be correct) but for your information, another Dr. XXXXXXX XXXXXXX said, it might be Chronic Chikungunya Arthirtis (PCCA)

4.I think your point (From your description of your arthritis, you seem to be having a condition called palindromic rheumatism.) is more closer to my problem as there is no damage or deformity to joints.

5. I am happy to hear that there is treatment for the same using medicines like hydroxychloroquine and it can prevent further attacks.(so shall I start taking the pills or shall I wait until I confirm this here locally)

only one request to you: please take your time but do complete analysis .

thanks
XXXXXXX

Answered by Dr. Divya Agarwal (12 hours later)

Hi XXXXXXX,

I went through your reports.

From your response and the reports, I feel we are dealing with palindromic rheumatism.

In addition, as you rightly pointed out post Chikungunya chronic arthritis is a persistent arthritis, not one that comes and goes.

In addition, it generally does not last for so many years unless it has progressed to rheumatoid arthritis.

Therefore, before starting the medicine you should see a rheumatologist, so that he can examine you and the medicine needs to be taken under medical supervision.

I hope I have been helpful.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Divya Agarwal (2 hours later)

Hi
Thans for the reply
In the repots the rhematoid facor is Negative , do you still think I might have RA?

Answered by Dr. Divya Agarwal (13 hours later)

Hi XXXXXXX,

You don't have RA, you probably have palindromic rheumatism and all our diagnosis are majorly clinical the blood tests contribute only 5 %.

Even RA can be seronegative in 25% people.

I hope I am clear.
Get back to me in case of any query.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Divya Agarwal (7 hours later)

Hi
Can you please suggest one good Dr. for PR in hyderabad here where after approaching he shoulldnt direct to other Dr's .

XXXXXXX

Answered by Dr. Divya Agarwal (24 hours later)

Hi,

I have two doctors for you in Hyderabad. You can choose one of them at the convenience of your location. Since you may need follow up choose one who is near to your area.

WWW.WWWW.WW WWW.WWWW.WW

You can write to YYYY@YYYY for easy appointment fixing with any of them.

Take care and please close and rate my answer if you do not have anything to discuss further.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar