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Noticed Rashes In Joints Of Legs, Hands And Chest. Diagnosed Early Symptoms Of Osteoarthritis. Suggestions?

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Posted on Mon, 22 Jul 2013
Question: Hello sir,
One month ago i had pain in some of my joints with rashes (mostly red)in my legs,chest and hands.My doctor gave me some antibiotics and medicines like allegra 180 & azid 500,after that my rashes and joint pain were eliminated with in few days.However my CRP was 36.8 and ASO was 162 during my illness.Recently i have developed a mild pain in my right knee with cracking like sound,i consulted a orthopedic doctor this time and he told i have early symptoms of osteoarthritis in my knees,he asked me to take x XXXXXXX of my knees and gave some blood tests like CRP,uric acid and glucose/plasma/fasting.My current level of CRP is 6.8,uric acid 6.8 and glucose/fasting/plasma of 102.I will XXXXXXX the orthopedic doctor tomorrow .Sir my age is only 23,i doubt i will have osteoarthirits at such young age although i am overweight with 97 kg of weight and my height is 5 feet 11 inches(i am also a weight lifter in gym so i donot look fat or obese).Do you suspect i have rheumatoid arthirits instead???should i ask my doctor for it??
doctor
Answered by Dr. K. Naga Ravi Prasad (1 hour later)
Hi, thanks for writing to XXXXXXX
It is very common to have generalized joint pains along with fever in some form of bacterial infections. Just because of the infection you had, both CRP (acute phase reactant) & ASO were positive for you. These are usually self limiting and resolve spontaneously as like in your case with proper medications. This is just for your information that C-reactive protein levels will take a minimum of 3-4 weeks to return to the normal values and the raised values are generally the result of infection or inflammation anywhere in the body.
Coming to the second part of the question, Osteoarthritis at your age is very unlikely. The crackling noise from the joint could be due to Patello femoral arthritis rather than osteoarthritis in your case. It means that the articular surface of the patella (kneecap bone) will be worn out producing the typical noise while rubbing against the femur (thighbone). This problem results in anterior knee pain which manifests as pain in the front portion of knee joint during bending movements as in climbing or descending staircase or getting up from a seated position.
Overweight will have a definite impact on the weight bearing joints such as knee and lead to early degeneration of joints. Also its necessary to keep a checkpoint for your weight.
Rheumatoid arthritis is very unlikely in your case as it is a "Polyarticular disease" (involves multiple joints) and typically involves the small joints of both hands.
In addition, regarding your Serum uric acid levels, the optimum value should be less than 6mg/dl. Keep monitoring these levels at least once in 2 months and if it goes high, it has to be treated accordingly.
Hope I have addressed all your issues. Happy to help if you need any more clarifications. Good day

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. K. Naga Ravi Prasad (4 hours later)
Hello sir,
First of all i would like to thank you for the prompt reply.Sir i was doubting that i may have Rheumatoid arthritis as after illness with hives and joint pains one month ago,i started to feel the weakness in knee (particularly right one) although all the other symptoms like pain in (joints of finger /ankle/elbow/hives or red patches)were cured after taking antibiotics within 2 days.But since you have ruled out RA as a possibility i am quite relieved.

Now after 1 month i have bad knees (which according to you is due to Patello femoral arthritis).Sir can X rays show this kind of arthritis?Do you advice to take any particular medication??will i need a therapy to fix this problem?What steps should i take to cure this form of arthritis?
doctor
Answered by Dr. K. Naga Ravi Prasad (25 minutes later)
Hi Mr XXXXXXX Yes one can get some amount of information on patellofemoral joint by having an xray of the knee joint in "Skyline view" & also lateral view. By these views one can easily define arthritic changes in the patellar articular cartilage. One can easily diagnose this condition by clinical examination by eliciting a positive "Clarke's sign" on the knee joint.
And the non invasive way of diagnosing the patellofemoral arthritis is by undergoing MRI scan of the knee joint, if you can afford it. One more way is by undergoing "arthroscopy" which will be both diagnostic as well as therapeutic.
I should not prescribe any particular medication on this site as per the regulations. So i advice you to consult an orthopedic surgeon for the same. I will let you know some general guidelines for your problem -
* Analgesic medications (preferably sustained release formulations) as and when needed.
* Glucosamine sulphate and Diacerin combinations for atleast 2 months
* Quit smoking, if you have the habit
* Physiotherapy in the form of Quadriceps strengthening exercises.
Hope these should resolve your issues. Good day
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. K. Naga Ravi Prasad (23 hours later)
Hello sir,
As per your advice i have taken an appointment from an orthopedic surgeon in my area due on monday.Sir can Patello femoral arthritis affect both knee joints at the same time?Today i have observed that both my knees are equally stiff and both are producing popping/cracking sounds and there is mild pain in my both my knees.I have taken X rays of both the knees to be shown to orthopedic surgeon on Monday.
doctor
Answered by Dr. K. Naga Ravi Prasad (11 minutes later)
Hi XXXXXXX

P.F.Arthritis may affect both knee joints but I feel that "simultaneous" involvement is a rare presentation. Anyway don't panic and consult the doctor.

Also, I appeal to you not to get confused or frustrated if the consultant surgeon diagnoses your problem as a different condition (as personal opinions may differ from surgeon to surgeon). Hope you got my point. Regards
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vasanth
doctor
Answered by
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Dr. K. Naga Ravi Prasad

Orthopaedic Surgeon, Joint Replacement

Practicing since :1996

Answered : 2148 Questions

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Noticed Rashes In Joints Of Legs, Hands And Chest. Diagnosed Early Symptoms Of Osteoarthritis. Suggestions?

Hi, thanks for writing to XXXXXXX
It is very common to have generalized joint pains along with fever in some form of bacterial infections. Just because of the infection you had, both CRP (acute phase reactant) & ASO were positive for you. These are usually self limiting and resolve spontaneously as like in your case with proper medications. This is just for your information that C-reactive protein levels will take a minimum of 3-4 weeks to return to the normal values and the raised values are generally the result of infection or inflammation anywhere in the body.
Coming to the second part of the question, Osteoarthritis at your age is very unlikely. The crackling noise from the joint could be due to Patello femoral arthritis rather than osteoarthritis in your case. It means that the articular surface of the patella (kneecap bone) will be worn out producing the typical noise while rubbing against the femur (thighbone). This problem results in anterior knee pain which manifests as pain in the front portion of knee joint during bending movements as in climbing or descending staircase or getting up from a seated position.
Overweight will have a definite impact on the weight bearing joints such as knee and lead to early degeneration of joints. Also its necessary to keep a checkpoint for your weight.
Rheumatoid arthritis is very unlikely in your case as it is a "Polyarticular disease" (involves multiple joints) and typically involves the small joints of both hands.
In addition, regarding your Serum uric acid levels, the optimum value should be less than 6mg/dl. Keep monitoring these levels at least once in 2 months and if it goes high, it has to be treated accordingly.
Hope I have addressed all your issues. Happy to help if you need any more clarifications. Good day