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Diagnosed With Fibromyalgia, Chronic Myofascial Pain Syndrome, Joint Hypermobility. Allergic To Medicines. Consult Whom?

Posted on Sat, 23 Jun 2012

Question: I am a 40 year old woman who was diagmosed with fibromyalgia, chronic myofascial pain syndrome, joint hypermobility, and hypothyroidism. I have been battling plantars fasciitis for a few years and was following my physiatrist's directions with regard to stretching. It got severely worse over the past year and I went to a podiatrist last week. He gave me shoe orthotics, a night splint, and said absolutely no stretching. He did xrays. He told me to go to PT 3x a week which I started. It got a little better and I went back to him. He wasn't satisfied with my very limited improvement and told me to bear no weight on my foot for 2 weeks and I got crutches. He also said he did not like the xrays of both feet because my heels are very "cloudy", he stated that the heels are suppose to be well defined in the xray and this cloudiness is a sign of a rheumatological disease, and he left it at that. I am concerned. what could it be? I was tested for lupus, west nile, RA a few years ago and all was negative. Could it be Hasimotos disease? I am severely allergic to alot of meds and chemicals and an allergist advised me in 1998 that blood tests showed I had antithyroglobin antibodies in my blood and they should be monitored because it could mean I have a predisposition for developing hashimotos disease. Any idea about what the cloudiness of the heels is indicative of? what specialist should i consult with next?

Answered by Dr. Praveen Jadhav (8 hours later)

Hello.

Thanks for posting your query.

I guess rheumatologist had diagnosed you with fibromyalgia and he is the best person to be consulted for your foot pain.

Form what you say, it is possible that you may be having an exacerbation of your plantar fasciitis. Apart from physiotherapy, intra lesional Triamcinolone is one of the best treatment for faciitis flare. However, you may need to confirm the diagnosis with a Rheumatologist.

Though, you may be having Hashimoto's thyroiditis, it is very unlikely to have any relation with your foot pain. Any hypothyroidism can cause joint pains, but involvement of foot joint is relatively rare. Hence, checking for antithyroglobin antibodies is unlikely of any help.

I hope, I have answered your query. Please accept my answer in case you have no follow up queries.

Regards.

Above answer was peer-reviewed by : Dr. Jyoti Patil

Follow up: Dr. Praveen Jadhav (3 days later)

What does the cloudy xray mean?

Answered by Dr. Praveen Jadhav (2 days later)

The cloudiness in Xray of the foot indicates -
either
1. An underexposed X-ray (a technical problem)
or
2. Swelling of the soft tissue in the foot. This can happen in plantar fasciitis, ligamental swellings, hematoma (blood) collection, trauma, arthritis, uric acid deposition, etc.

It must be understood that by itself, it is not diagnostic of any particular disease. X XXXXXXX is just the first modality of investigation and probably MRI could be a better option to pinpoint the cause of the condition. Final diagnosis is based on your multiple factors such as examination findings and results of the tests.

As mentioned earlier, Rheumatologist will be the best person to diagnose your condition rather than a podiatrist.

I hope, this answers your query. Please accept my answer in case you have no follow up queries.

Wish you good health.

Regards.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Jyoti Patil