Discussions By Condition: I cannot get a diagnosis.

Assortment of symptoms

Posted In: I cannot get a diagnosis. 1 Replies
  • Posted By: Assorted
  • July 11, 2010
  • 00:56 PM

I am a 27 year old female with a BMI approx 21. I am pretty healthy, work in a health-related profession, and exercise a moderate amount.
I have not wanted to whinge to my colleagues about my complaints and I have also not been sure if my complaints warrant further investigation, which is why I am here.

My background is: 2000, R knee reconstruction following ACL injury; 2006 L foot Lisfranc fracture/dislocation requiring surgery.
I have otherwise been well.

A year and a half ago I was travelling overseas and I became quite unwell - diarrohea daily for 6 weeks. Strangely, it wasnt with every meal and I couldnt pinpoint it to certain foods. I didnt even lose much weight, if any. Over the last year and a half, this stomach complaint continues every so often (perhaps once a week). Again I cannot determine what is the trigger. I had a blood test when it was severe, and I had raised inflammatory markers. A few months later when it still hadnt settled, I had a colonoscopy, and it was normal.

For as long as I can remember, I have always been fairly stiff in my joints if I sit still for a period of time or when I wake in the morning. It tends to affect my feet, knees, wrist and elbows in particular, bilaterally. It takes a few minutes for the stiffness to disappear once I get moving. However, sometimes I am not stiff.
Since last year, I have had on/off neck stiffness. I then developed severe right arm pain, and then bilateral severe pain in the region of my sacroiliac joints. To the point where I have found it difficult and sometimes impossible to sleep - this type of pain lasted months (about 4 months). I had a little manual therapy treatment in this time, which gave me very small symptomatic relief for a few hours. There was no position of comfort for either my arm or my pelvis, there was also no position I could find that would bring on the symptoms.
My right arm pain is much improved ( I couldnt hold a glass for weakness/pain). Neck CT was normal.
My sacroiliac joint pain is also much improved.
I now have a burning in my right buttock - this is worse when I sit or when I lie down (any position), and there is no position of comfort. It is therefore worse in the mornings and the evenings.
My arm I also notice mainly only when I rest: in the mornings or the evenings.
Both still affect my sleep.
My neck and back stiffness feel much better, though still fluctuate (keep in mind, I had a lot of movement to begin with, so my loss of range wasn't large)
My left heel has in the last few weeks started getting sore in the mornings, which improves once I get moving. Of the last few days, the discomfort has become constant, and is tender to touch.
Intermittently my right knee swells, so that I can barely bend it or walk on it. It is not painful, and the swelling lasts only 1-2 days.

I realise that my pains are on the same sides as my surgeries, but it did take 3-4 years for these symptoms to develop since the surgeries. Also, I am not sure, but I think my symptoms are worse when my stomach is worse. I have also been extroadinarily fatigued over the last few years. I now am quite particular about how much sleep I get, to see if it helps my symptoms.

My right buttock is particularly weak (I feel that that is a consequence of the pain, and not a cause) and I have no tenderness over my R ischial tuberosity. My leg muscles are a bit tight, but not exceptionally so. My posture isnt perfect, but its not bad. I usually swim a lot, but I haven't for quite some time, to see if it also had an affect on my pain. Sometimes I felt better for the swim and sometimes I felt worse. My job is quite physical, and while i think that has some bearing on my pain, again I do not think it is the cause, because my job is far from new and the symptoms progressed quite quickly within a few weeks.

I have now had the painful symptoms for almost a year.
The stiffness has been for many many years (fluctuating)
My knee swelling has been on and off for 8 years or so ( has happened maybe 6 times)

My half sister has psoriasis ( I am not sure which side of the family it comes from), and my mum has been tested for rheumatoid arthritis on multiple occasions and has had to take steroids: her hands in particular are very swollen with some deformities.

I feel like my symptoms are not severe enough to truly think of an inflammatory arthritic condition; yet I have so many symptoms and it is persisting for such a long time, I think I may need investigations.

What are others thoughts? Could this all be explained musculoskeletally? Are my symptoms linked? Should I be getting further investigations?

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  • Im not a doctor but my hobbie is to study medical stuff and thought i'd comment. What are others thoughts? Could this all be explained musculoskeletally? With the amount of different things you are going on there at your age, i think you have something other than a musculoskeletal issue going on and probably the diarrhea is connected. Im wondering if you could have either some kind of vitamin deficiency, an autoimmune issue or something like fibromyalgia. Let's look at the topic of fibromyalgia. * People with fibromyalgia get morning stiffness. This stiffness often goes away with some moving about and exercise may help fibromyalgia* They get pain in various places in body. Also, I am not sure, but I think my symptoms are worse when my stomach is worse.* In fibromyalgia the term "fibro flare" is common.. symptoms may flare up together. IBS often coexists with fibromyalgia.* People with fibromyaliga suffer from tiredness. *Some of your pain areas match the fibromyalgia trigger points (thou fibro pain can appear anywhere http://arthritis.about.com/b/2005/07/20/fibromyalgia-trigger-points.htmFibromyalgia trigger points are specific places on the body (18 specific points at 9 bilateral locations) that are exceptionally sensitive to the touch in people with fibromyalgia upon examination by a doctor. Fibromyalgia trigger points exist at these nine bilateral muscle locations: Low cervical region: (front neck area) at anterior aspect of the interspaces between the transverse processes of C5-C7.Second rib: (front chest area) at second costochondral junctions.Occiput: (back of the neck) at suboccipital muscle insertions.Trapezius muscle: (back shoulder area) at midpoint of the upper border.Supraspinatus muscle: (shoulder blade area) above the medial border of the scapular spine.Lateral epicondyle: (elbow area) 2 cm distal to the lateral epicondyle.Gluteal: (rear end) at upper outer quadrant of the buttocks.Greater trochanter: (rear hip) posterior to the greater trochanteric prominence.Knee: (knee area) at the medial fat pad proximal to the joint line." i suggest that you see someone who can test your fibro pressure points to find out if you have fibro. Also another thing which most wont be aware of.. certain injuries seem to happen more commonly in fibromyalgia patients eg frozen shoulder and issues like this (so there seems to be some kind of immune component in fibomyaliga). the one thing which dont fit thou is the knee swelling but i still think you should get fibromyalgia ruled out due to your symptoms.
    taniaaust1 2267 Replies Flag this Response
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