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Suggest Treatment For Persistent Tinnitus

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Posted on Tue, 18 Oct 2016
Question: 8 weeks ago I developed moderate tinnitus, 6 weeks ago my left foot began to swell and 4 days later I was admitted to the ER for intolerable foot pain. The swelling responds to prednisone but comes back regularly every 5-8 days in different locations on the left foot. I have been prescribed full regimens of cephalexin, sulfamethoxazole, and clindamycin all with no effect. I have also been given an ultrasound for a blood clot (negative) and been proscribed colchicine for possible gout, also with no effect. Lately my jaw has been very tight, and even when I can walk on my foot, I have mild joint pain in my wrists and ankles. My symptoms are not abating. My PCP is out of ideas. What can you suggest I try next?

doctor
Answered by Dr. Naval Mendiratta (8 hours later)
Brief Answer:
Is it vasculitis

Detailed Answer:
good evening

thank you for writing on health care magic

Well, it does look like an inflammatory process going on which started with tinnitus and has responded well to steroids. it definitely isn't Gout or pcp. I am not sure why pcp was thought in the first place as it is a very rare infection and hardly presents as arthritis

I would like a few more details

1. can you attach your blood tests especially esr crp and routine cbc

2. any skin rashes if you noticed recently

3. what did your doctor say about tinitus

4. any abdominal symptoms which you have experienced recently

We need to see if there is a link between tinnitus and arthritis. Some forms of vasculitis present this way.

Do let me know these queries

regarda
Dr naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta (2 hours later)
I will try to obtain blood test results. In the mean time, I have not had any unusual rashes or abdominal symptoms.

PCP is short hand for primary care provider, didn't mean to confuse you. My PCP doesnt seem to have any good theories, I'm planning on asking for a referal to a rheumatolgist tomorrow.

It's possible I was exposed to a tick bite a few weeks before the tinnitus developed, although I never noticed a rash or a bite. Is lyme disease a possibility or some other infectious agent that gained entry via my foot? I find it odd that the inflammation keeps reoccurring there in particular.
doctor
Answered by Dr. Naval Mendiratta (15 hours later)
Brief Answer:
Evolving arthritis

Detailed Answer:
Good evening

Sorry for the delayed reply. Had a long duty

Well, you need to seek an appointment with a rheumatologist. It looks like some form of arthritis which is evolving. The ones which come with ear involvement go more in favor of vasculitis...( another form of arthritis which can cause tinitus + joint pains and swellings)

I really dont think it s a Lyme disease. Normally rash does appear in it along with arthritis and usually fever accompanies it since it is an infection . But since you didnt have both , we can safely rule it out.

Blood results would have been useful. You can ask your GP to get a urine routine done along with a Chest Xray and some arthritis tests like RF, Anti CCP antibody, ANA, XXXXXXX and ESR, CRP...That would give us some clue where we are heading and while we wait for the appointment, we will have these results at least

Hope the information was useful. Do let me know for more queries

REgards
Dr navak
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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Suggest Treatment For Persistent Tinnitus

Brief Answer: Is it vasculitis Detailed Answer: good evening thank you for writing on health care magic Well, it does look like an inflammatory process going on which started with tinnitus and has responded well to steroids. it definitely isn't Gout or pcp. I am not sure why pcp was thought in the first place as it is a very rare infection and hardly presents as arthritis I would like a few more details 1. can you attach your blood tests especially esr crp and routine cbc 2. any skin rashes if you noticed recently 3. what did your doctor say about tinitus 4. any abdominal symptoms which you have experienced recently We need to see if there is a link between tinnitus and arthritis. Some forms of vasculitis present this way. Do let me know these queries regarda Dr naval