What Causes Bruises On Upper Arm Near Left Shoulder, Fatigue And Leg Pain?

Posted on Sat, 19 Mar 2016

Question: Hi I am 39yrs I have bruises on my upper arm near my left shoulder that appear a new one comes on just about every week I have been extremely tired pain in my legs and pain in my upper back just need some advice

Answered by Dr. Ilir Sharka (42 minutes later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome back on HCM!

Regarding your concern, I would like to know more about your relapsing left arm bruises:

-What color are they?
-What are the dimensions and their shape?
-Are they surrounded by a red erythematous skin? Are vesicles present on these lesions?
-Are they itching? Have you experienced fever recently?

This skin lesion, your back and leg pain are quite nonspecific symptoms, which could be explained by several inflammatory/infectious conditions such as a prolonged infection, a sepsis, but also immune reaction commonly seen after prolonged antibiotic regimen.

Coming to this point, I would like to directly review your left arm bruises.

Please could you make a photo and upload it here?

Meanwhile, I would like to advise you to check your body temperature and upload any available blood lab tests.

Hope to have been helpful!

I am waiting for your uploads for me to review.

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (8 minutes later)

Hi here are my photos also have been very fatigue during the day the pain in my legs are like cramps and the pain in my back is like throbbing I had 2 nosebleeds last week and my doctor added another blood pressure medicine Cozaar

I go for my monthly lab test next Wednesday I don't have a cold and underneath the left shoulder where the bruises are located I have not been injured seems like when one bruise is about to go away others pop up just want to make sure there is nothing wrong with my blood and any cardiac problems

I have sent my photos

Answered by Dr. Ilir Sharka (4 hours later)

Brief Answer:
My opinion:

Detailed Answer:

Hello again,

I reviewed your uploaded photo, and would say they look like small blood extravasation.

Probably because of increased fragility of blood vessels due to unrecognized micro-trauma, or because of decreased blood coagulability (predisposing for bleeding from several sites), or because of some degree of vasculitis promoted by a pro-inflammatory/infectious status.

In such case, some laboratory tests would be valuable in clarifying this issue:

- complete blood count (focusing to white blood cells for inflammation and platelets for bleeding),
- PCR and ESR (for inflammation),
- C3 and C4 components of complement cascade,
- bleeding time and coagulation time,
- INR (international normalized ratio)

It is necessary to discuss with your attending doctor on the above mentioned issues.

Also, a careful medical inspection for any further hemorrhagic symptomatology would be necessary.

Don't forget to check your body temperature.

Regarding your concern about any possible cardiac issue, I recommend you performing a cardiac ultrasound for investigating cardiac structure and function.

When any of the above tests become available, I would be glad to review them and give direct my opinion for you.

Regards,

Dr. Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar