Is Hip Surgery Safe While Having Deranged WBC Count?

Posted on Tue, 20 Oct 2015

Question: Hello. I have been experiencing joint pain and fatigue for almost one year. The past month I have been having low grade fevers (99.0-99.5), chills, worsening fatigue, and a moist cough going on three weeks. I find it very difficult to even take a shower. Just recently I saw a rheumatologist and she did blood work. My WBC came back at 3.6, monocyte % slightly high at 12.0, and neutrophil % slightly low at 46%. My ESR and CRP were normal, as well as my H/H and platelets. We repeated the tests...and now I am just waiting...any input on this? Also, I am supposed to have hip surgery on Monday...is this okay with a WBC below 4.0?

Answered by Dr. Swarnava Dattagupta (2 hours later)

Brief Answer:
surgery might be done; do the following tests

Detailed Answer:
Hello.
Welcome to HCM.
This is Dr. Swarnava Dattagupta answering your query.

I have gone through your query and understand your concern.
First of all, the WBC count is slightly deranged but that should not be a contraindication for surgery. Though the final decision lies with the anaesthesiologists, still the reports should be okay to go for surgery.
Anyways, what surgery are you going to have? And what are the joints you are having pain in? Also is there night time fever only?
Kindly answer the above so that I can help you further.
Also I would ask you to do the following-
Get a repeat blood count done after 2 weeks.
Also a sputum for AFB, sputum culture and PCR for tuberculosis should be done. Accordingly medication can be started. Also uric acid, RA factor and blood sugar should be tested to rule out causes of joint pain.

You can consult the above with your treating doctor.

Hope this was helpful.
Regards.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Swarnava Dattagupta (7 hours later)

Thank you for your thorough reply Dr. Dattagupta. The fevers have been throughout the day. I have not taken my temperature at night though. My joint pain I am having is in my ankles, shoulders, hips, wrists, and sometimes my fingers.

I am having a second arthroscopic surgery on my right hip on Monday. The first was last December where the surgeon shaved some bone spurs down as they were the cause of a significant labral tear which was also anchored down at that time. I continued to have hip pain and now am having a second scope to debride and release the iliopsoas tendon.

As far as blood work...I had a RA done years back in 2008 that was negative, so I guess that did not need done? Can that change over time?

Thanks, XXXXXXX

Answered by Dr. Swarnava Dattagupta (10 hours later)

Brief Answer:
follow as advised

Detailed Answer:
Hello.
You can go ahead with your operation with the blood counts you mentioned. There should not be any problem. Also, post operation, rehabilitation in the form of physiotherapy should be helpful. Your doctor will look after it I believe.
Now, the symptoms you mentioned might be because of various forms of arthritis or fibromyalgia if all blood reports come normal. Considering your age also, these are quite possible outcomes.
You can get the tests done as suggested. Also get the operation done as scheduled.

We can decide on a further treatment plan according to the reports etc.

Wish you good health.
Regards.

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