Brief Answer:
It can be cellulitis or soft tissue inflammation.

Detailed Answer:

Hi,

Thanks for sharing your concerns with us.

We will try to help you in the best way possible. First of all, it's sad to know what he had been going through lately.

Based on the history you have shared, it can be soft tissue inflammation or cellulitis of the affected arm of it's grossly swollen but Doppler ultrasound of arterial and venous systems of the said arm may be needed to look for patency of blood vessels in the arm and to rule out any sort of blockages. It is less likely related to being due to blood thinners as in that case bruising or blood collection under the skin called as ecchymosis needs to be present.

Bleeding inside the joint is even less likely and is usually in the patients with some bleeding disorders and present at an early age and doesn't stay somnolent until this late.

Similarly, vasculitis or joint inflammatory conditions are also less likely to present late but are still a possibility and not so uncommon so autoimmune workup like RA factors, ANA, and inflammatory markers like ESR and CRP will be needed. Uric acid levels and coagulation profile can also be done.

Complete blood counts to look for white cells to see for the possibility of acute infections like cellulitis needs to be done.

Meanwhile, OTC analgesics like Acetaminophen can be used for swelling. Topical Capsaicin or local anti-inflammatory gels like Ibuprofen can be used.

Get a detailed surgical or orthopedic consultation if the condition persists and if unremarkable a rheumatologist review can also be sought.

Wishing him a speedy recovery.

Hope this has answered your query.

Regards,
Dr. Saddiq Ulabidin,
General & Family Physician

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