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What causes extreme fatigue, swelling of hands and feet and joint pain?

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Posted on Mon, 16 May 2016
Question: I am experiencing the following symtoms: extreme fatigue, swelling of hands and feet, pain in joints (knees, hips, ankles, ankles & fingers). They did a test for Rheumatoid Arthritis, but it was negative. The pain is so bad, that is hurts to walk or stand. I am also getting migraines on a regular basis.
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I am sorry about the pain you seem to be in.

Looking at that description of your symptoms it looks like a case of inflammation of multiple joints, polyarthritis.
The most common cause for polyarthritis is rheumatoid arthritis so it is good that you have been tested for that. However the fact that the test resulted negative doesn't exclude the diagnosis. If as I assume what was tested was the rheumatoid factor it should be kept present that in almost 20% of rheumatoid arthritis patients it may come out negative.
The other common cause would be another rheumatological disorder which is lupus.
Other causes may include still disease, viral arthritis, sarcoidosis etc.

So the visit with the rheumatologist is really necessary to determine based on his physical exam and your history further tests to be taken (tests for inflammation, specific antibodies, imaging etc), as the causes can be many. It is started by more common ones, passing to rarer conditions when diagnosis is not clear.

I understand that you are in pain and it is hard to wait for that rheumatologist visit, especially thinking that he may ask for more tests to make a diagnosis. However I do not see any nonsteroid anti-inflammatory (NSAID) pain killer among your medication, you mention only tylenol and diazepam. You may take an over the counter NSAID such as Ibuprofen, Meloxicam, Naproxen etc which are much more effective than Tylenol for relieving such pain as yours. It is not a cure, but can help you feel better until the tests are completed.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3668 Questions

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What causes extreme fatigue, swelling of hands and feet and joint pain?

Brief Answer: Read below. Detailed Answer: I read your question carefully and I am sorry about the pain you seem to be in. Looking at that description of your symptoms it looks like a case of inflammation of multiple joints, polyarthritis. The most common cause for polyarthritis is rheumatoid arthritis so it is good that you have been tested for that. However the fact that the test resulted negative doesn't exclude the diagnosis. If as I assume what was tested was the rheumatoid factor it should be kept present that in almost 20% of rheumatoid arthritis patients it may come out negative. The other common cause would be another rheumatological disorder which is lupus. Other causes may include still disease, viral arthritis, sarcoidosis etc. So the visit with the rheumatologist is really necessary to determine based on his physical exam and your history further tests to be taken (tests for inflammation, specific antibodies, imaging etc), as the causes can be many. It is started by more common ones, passing to rarer conditions when diagnosis is not clear. I understand that you are in pain and it is hard to wait for that rheumatologist visit, especially thinking that he may ask for more tests to make a diagnosis. However I do not see any nonsteroid anti-inflammatory (NSAID) pain killer among your medication, you mention only tylenol and diazepam. You may take an over the counter NSAID such as Ibuprofen, Meloxicam, Naproxen etc which are much more effective than Tylenol for relieving such pain as yours. It is not a cure, but can help you feel better until the tests are completed. I remain at your disposal for further questions.