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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Swelling And Pain In The Elbows And Knees Be Treated?

My boyfriend, has swelling in his elbow, knee and fingers with severe pain that comes and goes. He has had the fluid drained and there has not been any signs of an infection. Bloods tests show high uric acid, but no crystals. Rheumatologist doesn t know what it could be. Any suggestions?
Wed, 8 Nov 2017
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General & Family Physician,  's  Response
hi

swelling in the knees elbows and fingers is commonly caused by:

1.Rheumatoid arthritis(especially if the pain is more in the small joints like fingers and associated with early morning stiffness)
2.Seronegative arthritis(psoriatic arthritis and other types of arthritis)
3.arthritis due to excessive formation of crystals(uric acid-causes Gout and other crystals pseudo gout)

initial lab tests normally include:
1.blood counts,ser,crp(quantitative),uric acid,blood for RA factor,blood for anti cop test(3rd generation anti cop test),Vdrl test,quantitative and qualitative ANA test(antinuclear antibody test),p-ANCA test.
2.urine routine and culture test.
3.advanced tests for autoimmune diseases like extractable nuclear antibody tests (ENA Test).

crystal induced non infective swelling of joints need to be treated with uric acid lowering drugs .

in view of the persistent autoimmune disease(mentioned under point 1and 2) needs to be ruled out.

very rarely gut autoimmune diseases like inflammatory bowel disease may cause such symptoms.

suggest second opinion with rheumatologist.

hope this helps

Regards
Dr.N.Ananth



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How Can Swelling And Pain In The Elbows And Knees Be Treated?

hi swelling in the knees elbows and fingers is commonly caused by: 1.Rheumatoid arthritis(especially if the pain is more in the small joints like fingers and associated with early morning stiffness) 2.Seronegative arthritis(psoriatic arthritis and other types of arthritis) 3.arthritis due to excessive formation of crystals(uric acid-causes Gout and other crystals pseudo gout) initial lab tests normally include: 1.blood counts,ser,crp(quantitative),uric acid,blood for RA factor,blood for anti cop test(3rd generation anti cop test),Vdrl test,quantitative and qualitative ANA test(antinuclear antibody test),p-ANCA test. 2.urine routine and culture test. 3.advanced tests for autoimmune diseases like extractable nuclear antibody tests (ENA Test). crystal induced non infective swelling of joints need to be treated with uric acid lowering drugs . in view of the persistent autoimmune disease(mentioned under point 1and 2) needs to be ruled out. very rarely gut autoimmune diseases like inflammatory bowel disease may cause such symptoms. suggest second opinion with rheumatologist. hope this helps Regards Dr.N.Ananth