Question about some test results

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Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 7/30/2010 4:50 PM (GMT -7)   
Hi Guys,
 
Again I need some advice on what might be going on.  I went to see the new Reumy, who ordered a large series of tests.  I had already had a series a month or so ago with my PCP, where my SED rate was high and my Uric Acid was high.  The tests my Reumy ordered showed only that I had high levels of CRP (C-Reactive Protein).  Lupus and Reumatoid tests were negative.  I don't yet have the results of my hand x-rays, but the ones on my back show ONLY scoliosis in the upper back and the results of the TLIF (that they said was PLIF).  All bone spurs were gone and no DDD was shown.  (These were only x-rays though...so they aren't exactly concrete and we should be getting the MRI next).  My thyroid cysts were the same as a year ago, with multiple cysts visable (and no problems on the blood tests).  Finally, the lipid panel showed colesterol really high and triglicerides at almost 500 and I'm still having horrible bouts of edema.
 
My question is basically does anyone have any idea what could cause a pain in the hands, high sed rate, uric acid crystals in the blood and high CRP levels with negative ANA, Lupus, and Reumatoid tests?  I'm at a loss here because there is obviously inflamation in my body that has continued for several months, but I can't seem to put it all together.  Plus, my back pain is realy horrible and I don't know what else to even ask for......I DON'T want to increase meds. 
 
Thanks for any response!
Retired Mom

golitho
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Date Joined Sep 2008
Total Posts : 1670
   Posted 7/30/2010 7:22 PM (GMT -7)   
Hi Retired, I'm not a doctor but do suffer from sero-negative arthritis and its very possible to have wierd blood results and still have an auto immune disease. High uric acid levels usually means gout but gout is often a side effect of auto immune diseases or linked to them, it doesn't mean you live on rich foods or it only affects your big toe! They're like shaggy dog stories or old wives tales.
 
Having sero negative arthritis myself , we present with often quite bizarre symptoms, so your best bet is to see your rheumatologist, they will make sense of it all for you. From my experience they go more on your symptoms than the blood work. People can have abnormal blood and yet not be troubled by any symptoms and others have perfect blood results and are plagued with swollen joints.
 
Are your joints swollen? Are they symmetrical as in both knees or both wrists?
 
My husband has gout and he also has high cholestrol, they are seemingly linked to his thyroid not working properly! Another auto immune condition. So don't worry about the bloods, in my experience they are a tool but not the only form of diagnosis. Good they caught your cholestrol levels now though so you can do something to fix it with diet and meds, less stress, etc.
 
Let us know what your rheumy says, good luck, golitho

sjkly
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Date Joined Dec 2007
Total Posts : 2113
   Posted 7/30/2010 7:23 PM (GMT -7)   
You can have RA and never have a positive rhuematoid factor test-or it could change any moment to a positve test.
As you mentioned SED and CRP measure inflamation. Obviously you have inflamtion.
High Uric Acid levels could mean you have or could develop gout. Chrystals develop in the joint space causing inflamation and pain. Occassionally one or more of the chrystals will become large enough-or lodged in the right place and will cause inflamation, heat and excruciating pain. Gouty arthritis (meaning not an extreem flare but some activity) can cause a dull ache that doesn't seem to go away.
Have they done any joint taps-extract fluid from the joint space and examine it by passing light through it to watch for the prismatic effect of chrystals? They probably would not have done that unless they could isolate an extreemly swollen joint.

White Beard
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Date Joined Feb 2009
Total Posts : 3611
   Posted 7/30/2010 8:11 PM (GMT -7)   
retiredmom

Gout would be my first guess, considering what you have told us, and gout can be extremely painful, it all depends on where the flare up is, in your fingers or thump or knees or you big toe or little ones, sjkly, and golitho are right on with what they wrote, ususually gout can be controlled easily with diet and medications, but it some times can be pesky too and difficult to get under controll. Usually with gout the joint is swollen and extremely tender even to the touch, and is also usually very red and feverish. Not always but this is how it ususally is in most people. Now I have rather deformed little finger that is very sore, and difficult to bend at the joint, it is not really swollen or red, it is tender to try and bend, and my other fingers are starting to follow suit, and I can not straighten any of them out flat, and mine is arthritis. The joints on the little finger are large and knobby and deformed.
Retiredmom you said your hand hurt, is your hand red and swollen and tender to the touch, or do you have any deformities or abnormal joints (locked or stiff) xrays will usually show what is going on with your hands. As far as your back goes, the MRI is the gold standard for what is going on there, I would not put much faith in just X-rays of the back. as they do not show cartilage or soft tissue, and whether or not any of your nerve roots are being impinged and thus causing you pain, because pain in just your hand or your arm could also be caused by a nerve in your neck having pressure being put on it. Last September when I had my C5-6 disk fusion, all my pain was in in last three fingers and the side of my hand and some in my forearm. but the pain was caused by pressure on the nerve root at C5/6 Immediately after they did the fusion the pain in my hand and arm was gone! So there are allot of things that could be causing your hand pain. They just have to find out what it is! Have they ever done an EMG study of your arm and hand? That could also be of help to show what is going on.

I do wish you well retiredmom! and Good Luck to YOU!

White Beard

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 7/31/2010 4:56 AM (GMT -7)   
Thank you everyone.  I appreciate the suggestions and please understand that I do not expect exact medical diagnoses and am seeing a Reumy, Endcrinologist, PCP, PM, Psych, Gyno, and whoever else they refer me to.  I do go to every Dr apt and take all the meds that I am prescribed exactly as they are given.  I know I have fibro, but I know fibro does not normally cause increased inflamation in the body or the high Uric Acid.
 
 
I will try to answer all of the questions, but please fogive me if I miss any.  My hand x-rays have been done, but I don't yet know the results.  My hands swell all over, at the knuckles on the fingers, at the base of the thumb, and at the knuckles on the base of the fingers.  I never know exactly which ones or when...it just flares up and does whatever it wants.  Both hands are affected.  When it is "just" the knuckles, the Voltaren Gel works immediately, but when it is the whole hand (overall stiffness/pain/swelling/no grip) then there is no relief.  Sometimes it gets a little better a few hours I have gotten out of bed.  My fingers go numb or tingle especially on the tips of a few fingers (especially the first finger on the left hand).  I have extreme sensitivity to cold or heat with my hands, but my body is almost ALWAYS hot and sweaty (even though my standard temp is 97.7).
 
I have not had fluid removed from joints for testing and I have not had nerve conduction studies.
 
My right knee bothers me a lot, but I can't really explain why...it just gets really painful and sometimes swells.  Then it goes down and I don't have problems for a while.
 
My feet and ankles are bad in the mornings and at night.  They are painful and achy, but don't generally turn red.
 
Lastly, I know you are all correct on the MRI vs X-rays of the back and hopefully I can get the MRI set up quickly.  X-rays (IMHO) are only as good as the person reading them and are not meant to show some things (as you guys pointed out).  The back thing is my worst problem, but the condition (whatever it may be) is making life so much worse with the constant pain in my hands.
 
I'm just looking for possible suggestions to explore.  You guys have a great deal of experience with so many conditions that I know nothing about.  I'm hoping to be able to discuss possibilites with the Reumy when I get to see her again.  We are so rural that she only comes to this area one half day one time per month and the next date is August 6th, but they don't have me scheduled.  I'm hoping to get past the "gatekeeper" answering the phone and get to a nurse or to somebody who can give me info on Monday.  So far, I've been unsuccessful.
 
Thanks again guys!
Retired Mom

Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 8/1/2010 12:05 PM (GMT -7)   
Thanks Pebbles!

I appreciate the encouragement and support!
Retired Mom
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