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Dr. Andrew Rynne

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Stiffness and pain in thigh. All test results are normal except ESR level. Now what can be done?

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Dr. Divya Agarwal

Rheumatologist

Practicing since :1999

Answered : 559 Questions

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Posted on Mon, 10 Dec 2012 in Lupus
Question: My wife was having stiffness and pain in her right tigh for which we saw a orthopadics last week & prescribed following investigations :
X XXXXXXX Pelvis B/L hips; C-Hemogram ESR; CRP; RA Factor; T3 T4; TSH; Anti CCP; 250 H Vit D3 Level.
All parameters are perfect except ESR (westergen) which is at 45 & the limit is <20 and Rheumatoid Factor is at 39.1 & the limit is <30.0.
After observations doctor said that this is the starting of Rehamutoid Arthiritis and advised following medication :
- Zerodol (to be taken for 10 days after dinner)
- Razo (to be taken for 10 days in morning empty stomach)
- Calcium tablets (to be taken for 1 month)
- Riconia (to be taken for 1 month)

Kindly advise whether the observations are appropriate and seriousness of the disease. Also, please suggest the way forward to the treatment.

doctor
Answered by Dr. Divya Agarwal 9 hours later
Hi XXXXXXX

Thanks for your query.

The symptoms you have stated are not corroborative with rheumatoid arthritis.
The rheumatoid factor is showing a very low titer and ESR is a non-specific test.
The treatment suggested is basically anti-inflammatory medication and not the one we generally give for rheumatoid arthritis.

I suggest that you need to get her evaluated by a Rheumatologist as she has an early arthritis. Sometimes tests may come out negative initially. What she needs is a detailed clinical examination.
I would like to know whether she suffers from back or heel pain or whether she has a positive family history for these.

Do get back to me with the details.

Regards

Above answer was peer-reviewed by : Dr. Mohammed Kappan
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Follow up: Dr. Divya Agarwal 2 days later
Hello Dr. XXXXXXX

Thanks a lot for your reply !

Luckily she doesnt have any problem like back or heel pain, but one of her aunt (maasi) suffered from RA but her mother/father & brother are absolutely fine.

Regards//XXXXXXX
doctor
Answered by Dr. Divya Agarwal 3 hours later
Dear XXXXXXX

Thanks for writing in.

I suggest that she may follow the medication prescribed to her for a few days.

If the problem resolves... good; if not then she may need further evaluation.
As I already stated that the medication prescribed to her is not the medication for rheumatoid arthritis.

Hope this helps. You can write back if you have any further queries; if not, please close this discussion and review.

Regards

Above answer was peer-reviewed by : Dr. Prasad
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