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What cises joint inflammation after recovery from fever?

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Internal Medicine Specialist
Practicing since : 2003
Answered : 959 Questions
My wife had a fever two months back. She recovered from within a week period. Post fever, she has been struggling with pains in joints especially ankles, foots.. Doctor precribed combiflam for a week time. After taking all prescribed dosages, the pains again started. Blood tests were carried out wherein Vitamin D and Vitamin B12 deficiencies were identified for which my wife takes medicines as per doctor's advice. But in parallel, the pains in ankles and foot continued. Consulted a rhumatologist. X rays of hands and foots were taken and found normal. Doctor did ultrasound screening and found inflammation in the paining areas. Finally he has prescribed to take predmet 16mg for 15 days (with progressive reduction in dosages- that is first 5 days - 16mg twice in a day, then next 5 days- 16mg in the morning and 8 mg in night, and last 5 days- 8 mgs twice in a day). After this cylcle, he precribed to take predmet 4 mg for another 15 days with progressive reduction as stated above. Now the question is, we come across about side effects of predmet tablet. Our concerns are mainly, what will happen after 30 days of taking predmet? Any major change in body shape or personality change like swelling at face, weight gain will happen? Her age is 43 years. She started taking the tablet from today, 31st XXXXXXX Kindly advice if it is safe to take predmet. If there are side effects, what precautions we should take ?
Posted Thu, 27 Feb 2014 in Bones, Muscles and Joints
Answered by Dr. Vaddadi Suresh 38 minutes later
Brief Answer: keep the dose of predmet to least. Detailed Answer: Hi, Thanks for writing in. I can understand your concern about your wife. Your wife probably had a viral fever like chickungunya or dengue. Both these, especially chickungunya can leave traces of joint inflammation for a long time. Answering your question, you are right that steroids can have side effects over long term usage. Many patients get best results only with steroids (like predmet) and these are much safer than pain killers when used judiciously for short term. However, after 2 or 3 months of usage, one may experience weight gain, edema etc that you were predicting. Much longer use can result in hypertension, bone loss and diabetes also. The best option you have now is to keep the dose of predmet to least i.e let her take 4 mg on alternate days rather than daily. If this dose is not achieving therapeutic response, i suggest you to add Tramadol which is a much safer drug than other pain killers. Keep in mind that these pains can last for months and hence rest to joints is a very important precaution that you must take. Hope I have cleared your doubts. All the best.
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