Diagnosis problems

 

Question  I am a 54 yr. old female. 10 months ago I became very ill and was hospitalized with septacemia suspected from a kidney infection. Liver enzymes were highly elevated and SED rate was very high. Subsequently had several more "septecemias". Had persistent pain in upper left abdomine.

Had to have a huge kidney stone removed (long history).Although stone removed, continue to have upper abdominal pain.(Not diagnosed) Kidney speciatist says not related to stones although CT scan shows many stones remain. Liver enzymes eventually returned to normal.

Approximately 8 weeks ago , developed acute sudden pain in hip that lasted several hours. Pain left the hip and went into both elbows and knees. Now seems to have settled in left elbow and knee which are both swollen. Have deformities of fingers in both hands (osteoarthritis) with big nodules. Sometimes get excruiating pain in left big toe.

Doctor says blood work is all normal. 3 different anti-inflammatories did nothing. Very high dose of Prednisone helped "somewhat" but now that dosage is tapered down, pain and swelling has returned.

Waiting to see a specaialist. Doctor says she suspects a "galloping" rheumatism of some kind, butis frustrated due to normal blood results.

Generally feel unwell and body temerature is very low (96.1 at times). No fever but get chills.

Any thoughts on what all this could mean??
 
Answer  I can never diagnose anybody over the web, but swelling of the big toe in the setting of a severe illnessa nd septicemia makes one think of gout, pseudogout or infection. Ask for a rheumatology consultation or if none is available, ask for a smart orthopedic surgeon (no, that's not an oxymoron).

Last update: 06:59 PM Thursday, April 12, 2007

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Author:

Alan Matsumoto, M.D.

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