Suggest tests to detect inflammation of joints and body

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Posted on Tue, 28 Oct 2014 in Lupus
Question: What tests do I run to know why my joints and body is inflamed. I have been on this for 5 months. It is gotten to the extent that I now take ibuprofen daily to reduce the pains. Have done comprehensive body test and nothing was seen by my doctor. Done hiv tests monthly for 4 months now all negative, syphilis negative, hep b and c negative, but the inflammation and joint pains continues. Done rheumatoid arthritis negative. Done urine culture nothing found , blood culture clear. What do I do. What tests do I do to discover what is wrong with me. My doctor can not place his hand on anything. Help if you can please.
doctor
Answered by Dr. Sudhir Kumar 40 minutes later
Brief Answer:
C Reactive protein,T3,T4 and TSH,VIT B12 &D

Detailed Answer:
Hi,
Thanks for your query.

I'm Dr. Sudhir Kumar,

After going through your query I concluded that you are suffering from nonspecific joint pains. You have done many tests. I will advise you to get following additional test in search of cause :-
1.C Reactive protein.
2.Kidney function test (serum creatinine)
3.Serum uric acid
4.Thyroid function test (T3,T4 and TSH)
5. Vitamin B-12 and Vitamin D3 levels

You also need complete clinical examination to know the cause. You can discuss with your treating Doctor about it. Do you have fever? Do you have morning stiffness? Whether pain is more on rest or on activity?

Hope I have answered your query.
If you have any further questions I will be happy to help.
Wishing you good health.
Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sudhir Kumar 36 minutes later
Thanks for your response Dr XXXXXXX The last time I did C reactive its was elevated and doctor suggested that it could be because of the sore throat or occasional pain in the throat which has also persisted till now. Occasional because the pain is not always there. I drink water and eat easily without pain but a pin like pain is still there.
My vitamin B-12 is normal. Have also done T3 is 1.93 (range is 1.3-3.1) T4 is 103 ( range is 66-181) TSH is 3.6 ( range is .270-4.20)

My Uric acid is normal at 7.5 (4.0-8.6), creatinine is high at 1.33(.7-1.2) however I do not know if this Uric acid and creatinine test are the ones you suggested because you indicated it should be Serum. Am not sure the one I did.
My vitamin D(1.25 Dihydroxy cholecalciferol - Serum is normal at 30.94 ( 3-70)
In addition I notice I occassionally have pains in my armpit and groin as if it lymph nodes producing the pains.

Again I do not have fever and the pain is more on rest and is hardly noticed on activity.

The last doctor I spoke with suggested it could be a viral infection but how do I identify the viral infection.
Sometimes after eating in the morning I become very weak and will have to wait to regain strenght before I continue with the day.
I await your further suggestions and advice.
doctor
Answered by Dr. Sudhir Kumar 2 hours later
Brief Answer:
May be reactive arthritis.

Detailed Answer:
Hi,
Welcome back.

Your report are normal except increased C reactive protein which signifies that inflammation is there. Creatinine is slightly raised ,it is of no significance.Uric acid and creatinine are same which I suggested,no worry. After going through your query ,follow up query and investigation reports possibility of two diseases came in my mind because your pain is more on rest and hardly noticed on activity.

1.Reactive arthritis:- It is arthritis which occur as body reaction after many infections including viral infection or fever. Nearly all joints of body are involved and it may last for many months sometimes even up to one year. There is no specific test for it. This is treated on clinical ground. I treat my such patients on clinical grounds by injection Triamcinolone intramuscular once in a week till he got significant relief with very good results. Analgesics are given for pain relief which you already taking. You can discuss with your treating Doctor about it.

2.Seronegetive rheumatoid arthritis:-This is mild form of rheumatoid arthritis in which rheumatoid factor test is negative(20% cases of RA). However 5 months period is early to label as rheumatoid arthritis.

Further you have mentioned of painful lymph nodes in armpit and groin. Biopsy of lymph nodes may add to diagnosis and exclude other diseases but at this stage I will not recommend biopsy.

Hope I have answered your query.

If you have any further questions I will be happy to help.

If you do not have any clarifications, you can close the discussion and rate the answer.

Wishing you good health.
Take care.

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Sudhir Kumar

Orthopaedic Surgeon

Practicing since :1993

Answered : 3338 Questions

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