What Causes Pain In Chest And Joints Inspite Of Normal Blood Tests?

Posted on Mon, 14 Apr 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 14 Apr 2014 Answered on

Mon, 5 May 2014 Last reviewed on

Question : I have been diagnosed with fibromyalgia, but I think that is because my doctor really can't pinpoint what my problem is. My pain continues to get worse despite trying all the medicines prescribed for fibromyalgia - nothing has helped. I have increased pain in my chest - which started with deep breaths - now with every breath. I have paid in all my joints - worse in my hips, but also in wrists, elbows, knees, ankles, and feet. Pain in my neck is increasing also. I have numbness in my fingertips and my big toes. Sometimes one hand is colder than the other, same with feet. (maybe TOS but that's another hard one to diagnose) Blood tests have not shown RA, but I don't know if I should have them check again. My pain and stiffness is increasing - I can barely get out of bed in the morning. Help ..

Answered by Dr. Karl Logan (47 minutes later)

Brief Answer: Still sounds like inflammatory arthritis Detailed Answer: Hi, This sounds like a really difficult problem for you to deal with. There are types of inflammatory arthritis that exist where the standard blood work is normal but the patient still exhibits symptoms and signs consistent with this diagnosis. I would encourage your Dr to refer you to see a rheumatologist where further investigations can be done to try and make a diagnosis. These may include further blood work, X-rays and MRI scans of the affected joints. Sometimes anti-rheumatic drugs are trialled to see if the patients symptoms improve even in the abscence of a firm diagnosis. Occasionally joint and or muscle biopsy can be done to help may a diagnosis. I hope this information is of benefit Best wishes

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

Follow up: Dr. Karl Logan (3 hours later)

I am not sure where to ask for the MRI, where it hurts the worst? Or all the joints that hurt? Should I ask for a bone density test? It seems the pain is in all my joints and even my bones, this could affect my muscles, right?

Answered by Dr. Karl Logan (5 minutes later)

Brief Answer: Any affected painful joint Detailed Answer: As long as it is an affected joint it doesn't matter which one they MRI. Intravenous contrast should be given to see if the synovium( the lining of the joint ) is inflamed. A bone density DEXA scan will tell you if you have osteoporosis although this may not be responsible for your symptoms. Osteoporosis usually only causes symptoms when you have a fracture because of weaker bones. Therefore talk to your treating doctor before DEXA scan. Best wishes

Above answer was peer-reviewed by : Dr. Prasad