Dear Ask The Doctor: Dear Doctor I am a 34 year old female (married, with a son aged 6 yrs), having sporadic pain in the joints. It could be knees, elbows or finger joints. The first episode of this pain occurred 1 year ago with severe pain in my left knee that lasted for almost 2 weeks to the extent that at one point I was limping. Just when I was thinking of consulting a doctor, the pain relieved and I have had very minor episodes of pain on and off. But since January this year, again, the pain has surfaced. This time it is the hands. elbows, wrists and the ball-socket joint of my arms hurt like crazy. It feels like a pinching pain in the bone. The affected part cannot be moved without severe pain. Again this lasts for a few days and disappears on its own. Today, I have severe pain in the fingers of the left hand. The joints of the 2 mid fingers are hurting and cannot be straightened. the base looks swollen above the joint. I am not able to hold anything with this hand. With this information, is it possible to diagnose what might be the underlying condition? What should I be doing? Should I consult some specialist? if so, which one? Please let me know what to do. Regards NMT
Dear NM: The multiple joint pain may have several causes, for example: inflammatory diseases (rheumatoid arthritis), autoimmune issues (scleroderma, lupus), osteopenia (low calcium in the bones), metabolic diseases (high cholesterol, gout, parathyroid problems), muscle problems (polymyositis), once that you rule out all the mentioned causes and in the view that you are young and active, it would be important rule out possibly a fibromyalgia. I strongly recommend you to have a consultation with a specialist: Rheumatologist, who will evaluate you and will order the appropriate lab test and possibly other specific tests that may involve determination of muscle electrical activity or/and skin tests.