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Suggest Treatment For Joint Pain After Medicine For TB

Posted on Sat, 20 Sep 2014

Question: Sir
I am a 34 years male. I was diagnosed with bone tuberculosis in July 2012 of right hip joint two years ago.I was on Anti Tuberculosis Treatment for 18 months which was completed 6 months back but i am still having pain on my right hip joint and my right hip joint space also reduced. i was also on one month physiotherapy two moths back which only increase my pain. my latest ESR is 44, C-Reactive Protein is 13.23, Rheumatoid Factor is 8, Anti-CCP is 7 and HLA-B27 test is negative. My latest MRI of Both hip joint report and Blood reports are also attached herewith for your kind reference. kindly suggest me what treatment i should opt now.
Presently i am taking these medicine (pain killer)
1. Indocap S.R.
2.PANTOCID DSR

Answered by Dr. Dr. Alokkalyani (13 minutes later)

Brief Answer:
spondyloarthritis

Detailed Answer:
Hi
I m dr Alok, rheumatologist, pleased to answer your health related query
With your history, it seems that you have spondyloarthritis. Get an xray of pelvis done and see a rheumatologist as soon as possible.
Your previous diagnosis of bone tb was wrong
Might be hla-b27 is negative, still possibilities of spondyloarthritis is good
Hope this will help

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Alokkalyani (28 minutes later)

Dear Sir,

Thanks for your prompt reply.
Sir, i am attaching previous MRI report on which basis i was diagnosed TB by doctor on july 2012 (annexure 1). as suggested by you i am attaching pelvis xray report of XXXXXXX and may 2014 in aneexure 2 and 3 respectively.
kindly suggest.

Answered by Dr. Dr. Alokkalyani (2 hours later)

Brief Answer:
wrong report

Detailed Answer:
Hi, MRI is not diagnostic for tb, it is confirmed either by biopsy or by synovial fluid to be aspirated and examined,
I advised you to review MRI films - sacroilic joints by a expert. I have seen many misdiagnosed patients

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Alokkalyani (8 hours later)

Hi Sir,

in that case can u please tell me why my hip joint space has been reduced as shown in reports.

Answered by Dr. Dr. Alokkalyani (44 minutes later)

Brief Answer:
due to spondyloarthritis

Detailed Answer:
Reduced Joint space is due to many disease including any infection, sponsyloarthritis etc.
Your report is not indicating to a particular disease

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. Alokkalyani (9 hours later)

Hi sir
Can u please tell me what is the treatment for spondylorthritis and is it completely curable

Answered by Dr. Dr. Alokkalyani (3 hours later)

Brief Answer:
not curable

Detailed Answer:
I advised you to confirm it by ESR, crop hla-b27 report (by pcr method) and MRI of sacroiliaic joint
Thus is not curable but well treatable. You need to see a rheumatologist for evaluation and management. There are two groups of medicine available- DMARDs and biologics

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

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju