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Suffer extreme fatigue, joint pain and swelling. Feeling tightness around chest. Have dark circles around eyes. Suggestions?

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General & Family Physician
Practicing since : 2009
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I have symptoms of extreme fatigue, joint pain and swelling (mostly knees hips fingers), feeling of not being able to take a deep breath and a "tightness" around my chest at the altitude of just under arm pits(I have had cardio tests...passed with flying colors" there is a pressure in the front crease of my arm/torso crack. Pain in body makes moving at night painfully stiff and wakes me. I have much iliac crest area pain and lumps inside my body all around that area. When it is at its peak, I have dark circles under eyes. Do these symptoms seem to indicate one or more illnesses I should check into.
Posted Sun, 4 Aug 2013 in General Health
Answered by Dr. Luchuo Engelbert Bain 3 hours later
Hi and thanks for the query,

I am afraid what you describe deserves a more careful clinical review. A rheumatologic condition must be checked and excluded first. A family history of rheumatoid arthritis, systemiclupus erythematosus are important. With respect to chest tightness, its already reassuring your cardiac work up was unremarkable. Past history of asthma or night cough or tightness could be helpful.

It s necessary to have a complete rheumatologic work up. Measurement of serum Rheumatoid factor for Rheumatoid arthritis, Anti Nuclear Antibodies, Erythrocyte Sedimentation Rate, complete blood count on search of anemia or low platelets and white blood cells could give insights with respect to rheumatoid diseases like lupus, rhuematoid arthritis, mixed lumps in the iliac region, especially if the is a past history of having lived in a tropical country, or Onchocerciasis endemic region, to exclude for onchocerciasis. Biopsy and histologic analysis of these nodules could be helpful. A chest X rays and Respiratory function tests might give big insights into causes of respiratory symptoms.

A proper clinical review is the key issue. Based on the findings and correlations with various aspects of your past medical and family history, appropriate laboratory and radiologic tests shall be asked. Other medical specialities could then be involved to improve diagnostic and management outcome.

I strongly recommend booking an appointment with an INTERNIST FIRST. Thanks and hope this helps as I wish you the best of health. Thanks and kind regards. Feel free asking further questions if need be.

Kind regards,

Bain LE, MD.
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