Brief Answer:
You seem to have migratory arthritis- there are many conditions that may cause this, so some more information is needed

Detailed Answer:
Hello and welcome to 'Ask a doctor' service,

I carefully read your query.

There are several causes of swollen and painful joints in the leg.

In your case, because the swelling and pain moves from one joint to the other, you have migratory arthritis. Migratory arthritis can be caused by immune conditions (sarcoidosis, systemic lupus erythematosus SLE, rheumatoid arthritis, etc), or infections (Lyme disease, endocarditis, gonococcal arthritis and Whipple's disease which may affect the bowel and joints). In some cases, crystals depositing in the joints may cause such symptoms as well.

Knowing some more information will help us better understand the cause of migratory arthritis in your case.

So, it is important for us to know:

- Do your joints get red and hot when you have the swelling?

- Do you have a stiffness that lasts more than 30 minutes in the joints?

- How long does the swelling and pain in one joint last and how long it takes before it affects another joint?

- Do you have any skin rash or lesions in the mucosa (eyes, mouth, nose)?

- Do you have increased vaginal secretions or other symptoms of a sexually transmitted disease?

- Do you have any fever, general weakness, weight loss?

- Do you have any cough, shortness of breath, abdominal pain or diarrhea?

- Have you had any tests done such as CBC, ERS, chest x-ray, or other?

Because the list of the diseases that may cause migratory arthritis is quite wide, sometimes, some tests may be needed, other than the history and examination. Let us know of the above information so I can further assist you.

I hope this gives some answers to your query and also that you will let us know soon of the above information.

I remain at your disposal for further medical assistance.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

The presence of redness and heat with the swelling and pain shows that there is inflammation in your joints. In this case, some tests may be done to rule out connective tissue disorders (an autoimmune disease such as RA, SLE, sarcoidosis, rheumatic fever, etc) and infections:
- CBC, ERS, CRP
- RF, ANA,
- chest x-ray
- gynecological exam and cervical samples for gonorrhea
- if you think you are at risk of Lyme disease, blood tests for Lyme can be conducted
- examination of the joint fluids can be ordered if crystals are considered the cause
- in case endocarditis is suspected you may need a heart ultrasound, ECG and blood culture

Your doctor will need to take a thorough history from you and do a thorough physical examination and according to the information gathered from these, he will decide on the tests needed in your case.

Symptoms of the sexually transmitted disease are increased vaginal secretions, abdominal pain, pain with intercourse, urinary frequency and burning, fever, weakness, nausea, etc.
The patient may have a few of these symptoms and in rare cases, most of these symptoms. In a few cases, patients may have gonococcal arthritis even if they do not have genitourinary symptoms so it may be advisable to anyway have a gynecological exam and cervical samples for gonorrhea.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

It is good that RA is ruled out. As I mentioned above, there are several other tests to be done to rule out other conditions as well.

I would recommend you to talk to your doctor and discuss the possible causes and possible examinations that may help to diagnose the cause of arthritis in your case.
The doctor, after examining you, will better determine which of the above-mentioned tests is necessary in your case and if other tests will be needed as well.


I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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Brief Answer:
You will need to be followed up to diagnose the underlying cause

Detailed Answer:
Hello and welcome back,

Without a diagnosis, the doctor will only give pain killers to help with the pain and swelling but will not treat the cause of arthritis.
I would advise you to continue the checks with the doctor to determine the diagnosis and treat the underlying cause of arthritis.
Some conditions can be dangerous if they are not diagnosed and treated properly. For instance, rheumatic fever, Lyme disease, gonococcal arthritis, Whipple's disease, endocarditis, if present, need urgent treatment with antibiotics.

So, yes, I would say it is in your best interest to continue the checks to find the cause of the joint problems you have so you do not take only pain killers but treat the underlying disease as well. This will give better control of the pain and other symptoms of the joints but will also prevent any serious complications, depending on the diagnosis.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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