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Suggest Treatment For Swelling And Pain In The Bone Joints
Question: What would cause swelling and pain in the joints -- Thursday morning right ankle swollen and painful, then right knee later in the day had swelling and pain that got better with indomethacin. Friday night, left knee and elbow started to ache and Saturday woke to what I suspected was a full fledged gout attack, continued with indomethacin. Started icing. Sunday morning went to Urgent Care. Recieved stroner indomethacin (50mg -75Mg) and Norco 5-325mg. Not any better and right leg is now stiff and sore and botttom of leg from top of knee down to foot is swollen.
Brief Answer:
could be gout...
Detailed Answer:
Hello,
if you do have a history of gout then gout is likely. Otherwise it's not common - particularly for the first event - for gout to present with multiple joint involvement, although it's possible. The involvement of the large joints draws the thought away from various chronic conditions like rheumatoid arthritis or lupus because the small joints first are usually involved first.
Other forms of arthritis like reactive arthritis or ankylosing spondylitis are also possible but more symptoms are usually present like back pain or back rigidity.
The most accurate way to diagnose gout is to examine the synovial fluid. Examining the fluid also excludes bacterial causes (in single joint insults).
Indomethacin in high doses (150mg per day) is usually effective to relieve the inflammation in gout attacks. A history of peptic ulcer (or bleeding), renal problems (elevated creatinine for example), uncontrolled hypertension, etc may be relative or absolute contraindications to indomethacin. Colchicine is an effective alternative which can also be used between attacks.
So in conclusion, in patients like you I would have asked either for a positive gout history or for fluid aspiration to confirm gout. If gout is indeed the diagnosis then indomethacin is an appropriate treatment. It may take some days to resolve. If it gets worse then other treatments can be tried (corticosteroids for example). Don't try any of the alternatives without your doctor's consent.
I hope it helps!
Kind Regards!
could be gout...
Detailed Answer:
Hello,
if you do have a history of gout then gout is likely. Otherwise it's not common - particularly for the first event - for gout to present with multiple joint involvement, although it's possible. The involvement of the large joints draws the thought away from various chronic conditions like rheumatoid arthritis or lupus because the small joints first are usually involved first.
Other forms of arthritis like reactive arthritis or ankylosing spondylitis are also possible but more symptoms are usually present like back pain or back rigidity.
The most accurate way to diagnose gout is to examine the synovial fluid. Examining the fluid also excludes bacterial causes (in single joint insults).
Indomethacin in high doses (150mg per day) is usually effective to relieve the inflammation in gout attacks. A history of peptic ulcer (or bleeding), renal problems (elevated creatinine for example), uncontrolled hypertension, etc may be relative or absolute contraindications to indomethacin. Colchicine is an effective alternative which can also be used between attacks.
So in conclusion, in patients like you I would have asked either for a positive gout history or for fluid aspiration to confirm gout. If gout is indeed the diagnosis then indomethacin is an appropriate treatment. It may take some days to resolve. If it gets worse then other treatments can be tried (corticosteroids for example). Don't try any of the alternatives without your doctor's consent.
I hope it helps!
Kind Regards!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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