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What Causes Severe Joint Pain When ESR Count In Blood Is 18mm/hr?
Question: My 12 years old daughter is getting joint pains and pathological investigation shows ESR 18mm/hr . She is advised Penidure LA 12 lacs injection once a week and it is very painful to the best of my knowledge. If there is any substitute in tablet form or any other alternative? Your prescription, please, in reference to the blood report given below.
BLOOD REPORT
W.B.C.-8100 Per cu mm / PLATELETS-Adequate Per cu mm /RBC-3.75 Million per cu mm / HAEMOGLOBIN-75%=11.0gm% / NEUTROPHOLS-61% / LYMPHOCYTES-35% / EOSINOPHILS-3% / BASOPHILS-0% / ESR-18mm per hour / SUGAR(F)-84.3 mg per dl / URIC ACID-4.3mg per dl / ASO TITRE-POSITIVE IN 200.01.U per ML / RA TEST-NEGETIVE.
- Napu XXXXXXX
BLOOD REPORT
W.B.C.-8100 Per cu mm / PLATELETS-Adequate Per cu mm /RBC-3.75 Million per cu mm / HAEMOGLOBIN-75%=11.0gm% / NEUTROPHOLS-61% / LYMPHOCYTES-35% / EOSINOPHILS-3% / BASOPHILS-0% / ESR-18mm per hour / SUGAR(F)-84.3 mg per dl / URIC ACID-4.3mg per dl / ASO TITRE-POSITIVE IN 200.01.U per ML / RA TEST-NEGETIVE.
- Napu XXXXXXX
Brief Answer:
Further evaluation is needed
Detailed Answer:
Hello
Thanks for asking on this platform
I have gone through the details and all the investigations are within normal limit.
Penidure contains penicillin and is given for prophylaxis or treatment of streptococcal infection.
Join pain in this age can be due to so many reasons and streptococcal infection is one of them.
In streptococcal infection the ASO titre should be raised (200 is normal).Streptococcal arthritis can not be labelled only on the basis of ASO titre.One should go for anti DNAse B level to confirm the diagnosis.
I request you to give me elaborate history like which joints were involved,for how long,was there any swelling or redness,was the joint pain migratory (involvement of one joint followed by improvement and later on involvement of another joint),is the pain more in morning,any associated symptoms like cough,fever,increased hear bear or breathing problem.Answer of all these question will give a clue towards the diagnosis.
I request you to get a second opinion from a rheumatologist for conformation of diagnosis.
You are right that Penidure injection is very painful.There are substitutes like oral penicillin V or erythromycin but problem is that these oral medications need to be taken daily while one injection every 21 days or 28 days is sufficient.
Please get back to me if you have any more queries.
Regards
Further evaluation is needed
Detailed Answer:
Hello
Thanks for asking on this platform
I have gone through the details and all the investigations are within normal limit.
Penidure contains penicillin and is given for prophylaxis or treatment of streptococcal infection.
Join pain in this age can be due to so many reasons and streptococcal infection is one of them.
In streptococcal infection the ASO titre should be raised (200 is normal).Streptococcal arthritis can not be labelled only on the basis of ASO titre.One should go for anti DNAse B level to confirm the diagnosis.
I request you to give me elaborate history like which joints were involved,for how long,was there any swelling or redness,was the joint pain migratory (involvement of one joint followed by improvement and later on involvement of another joint),is the pain more in morning,any associated symptoms like cough,fever,increased hear bear or breathing problem.Answer of all these question will give a clue towards the diagnosis.
I request you to get a second opinion from a rheumatologist for conformation of diagnosis.
You are right that Penidure injection is very painful.There are substitutes like oral penicillin V or erythromycin but problem is that these oral medications need to be taken daily while one injection every 21 days or 28 days is sufficient.
Please get back to me if you have any more queries.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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