I have gone through your reports (attachment removed to protect patient identity). Your inflammation markers are very high (erythrocyte sedimentation rate and C-reactive protein). So, it does indicate either there is an infection or inflammation. I need more history to confirm it. Your arthritis tests are negative, but then again we can have arthritis even when the rheumatoid factor, anti-cyclic citrullinated peptide, and anti-nuclear antibody are negative.
Kindly provide me with the medical history and I will be able to guide you better.
Thank you doctor,
I have pain and swelling in the knees and ankle for the past three weeks. I am taking medication for asthma, blood pressure and cholesterol for the past seven years (prescription attached).
It does look like some form of arthritis is involving your lower limb joints, knees, and ankles with high inflammatory markers (erythrocyte sedimentation rate and C-reactive protein). I would suggest you start tablet Nucoxia (Etoricoxib) 90 mg once daily. Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent. Consult a rheumatologist as you may need to start your medications as early as possible. It is tough to say how long you will need to take the medicines as we need to see which form of arthritis you fit into.
I hope this helps.
The Probable causes:
The probable cause is spondyloarthropathy.
Investigations to be done:
The investigation to be done is HLA B27 ( human leukocyte antigen B27) (polymerase chain reaction method)
Avoid sitting on the floor in cross-legged position.
I have reviewed your reports (attachment removed to protect the patient's identity). As suspected, your HLA B 27 has come out positive which may be the reason for your ankle and knee swelling. Your CRP (C-reactive protein) is better than last report. So, I believe your swelling is coming down. There is a possibility that you had an episode of reactive arthritis. If it persists for more than three months, you may need a long term treatment for the same. Kindly let me know if your symptoms are persistent or have improved and also the medications that you are taking, so that I can guide you further.
I hope this helps.
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Same symptoms doesn’t mean you have the same problem. Consult a doctor now!
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