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What Causes Extremely Hot Red Palms, Elbows And Knees?

Posted on Mon, 17 Nov 2014

Question: Hot red palms (extreme) , elbows, & knees (all recent). DX with RA & Fibro 3.5 yrs ago and then DX with hypogammaglobulinemia 1.5 yrs ago. RA doctor doesn't think it is RA. Please advise.

Answered by Dr. Dr. Naveen Kumar Sharma (1 hour later)

Brief Answer:
It need a little detail about your illness

Detailed Answer:
Hello,
Redness in palm or any other joint is not a common feature of Rheumatoid Arthritis. It is commonly seen in GOUT or other skin related conditions. Before I advise you anything I want to know little detail about your illness?
1. Since when you have these red palms and elbows?
2. Are you having joint pain and stiffness also? Or any other complaints?
3. Have you done any investigations like ESR, CRP or Ra factor recently? If yes please send me these reports also
Please send me answers of these questions. I will try my best to help you.
Thanks.

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

Follow up: Dr. Dr. Naveen Kumar Sharma (5 days later)

I was extremely detailed in my question posed to WebMD I was still asked to provide more "Detailed" information. However, short of a blood, hair, urine and stool sample I don't know what other "Detailed" information I could provide and I don't have Radiological or Laboratory results in my pocket to send to either assist or prove my diagnoses. I figured that I would get some sort of "...... differential diagnosis and/or other differential diagnoses could be......". I didn't think I would receive a commit statement "..... THIS IS WHAT YOU HAVE AND THIS IS WHAT YOU NEED TO DO...." but I get the response "....MORE detail needed...". I will pay my Physician his co-pay for a Definitive answer.
XXXX

Answered by Dr. Dr. Naveen Kumar Sharma (1 hour later)

Brief Answer:
Your symptoms are due to RA

Detailed Answer:
Hello,
I have studied your case and I have asked few specific test. We do not need urine or hair or any other test. For confirmation of RA a person should have RA test positive with raised ESR. ( above 30 )
You mentioned that you have red palm , and joint . It is not due to hypogamaglobulinemia or fibromyalgia. It can be either due to Rheumatoid arthritis or a drug reactions. So I would suggest you to discuss on going medicines with your doctor. If you are taking Hydrocholroquine,Methotrexate or Steroid than these drugs can cause such red joints.
If you want my opinion, send name of drugs you are taking right now. I can tell you which drug is causing problems in your case.
Thanks.

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

Follow up: Dr. Dr. Naveen Kumar Sharma (38 hours later)

I am currently on Hydrochorloquine 200mg twice daily and I have been on this medication for almost a year. Why would I develop issues with this medicine now? My mom has diabetic neuropathy and she said it sounds like the same symptoms. I have been checked for diabetes and I have tested negative. I broke my elbow a few months ago and I used an ice back on the way to the hospital, however I didn't realize that I gave myself freezer burn and the ER doctor thought it was no big deal. I do have pictures of that somewhere if you need to see.

I forgot to mention that I am also on Gabapentin 2400mg total daily.

Answered by Dr. Dr. Naveen Kumar Sharma (12 hours later)

Brief Answer:
You can have that due to Ra also

Detailed Answer:
Hello,
I have studied your case and HCQ can cause such issues. Also it can be due to RA. I would recommend you to meet your doctor and discuss these lesions.
Gabapentin or neuropathy do not cause such lesions.
I would also like to ad that taking singk tablet for RA is not sufficient. You should add SAZ and methotrexate.
Thanks.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Dr. Naveen Kumar Sharma (11 hours later)

I have been on the methotrexate and it tore me up the biggest issue was vomiting. I don't understand why you refer to my hot palms and feet as "lesions", please advise. So I should meet with my RA doctor?

Answered by Dr. Dr. Naveen Kumar Sharma (2 hours later)

Brief Answer:
You should see skin specialist

Detailed Answer:
Hello,
I have called this lesions on the basis of image. It is more like a dermatitis. So I think it is more like a drug reaction. There can be other causes of allergic reaction also. So my recommendation is that along with RA doctor, you should also see skin specialist. Single HCQ is not sufficient to tackle RA.
Thanks.

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

Above answer was peer-reviewed by : Dr. Yogesh D