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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46726
Experience:  Board Certified Physician
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I have what feels like tendon pain in my forearms at the elbow,

Customer Question

I have what feels like tendon pain in my forearms at the elbow, most of my first knuckles, in my out hip areas and also the groin. It started in my forearms and very slowly got worse over about a year. It is more accurate to describe the sensation as tenderness and mild discomfort rather than pain but it has me very worried. I have not responded to several different types of prescription anti-inflammatories such as naproxen and celebrex. I have also been put on a course of glucosamine and chondroitin by my rheumatologist but to no effect. X-rays have not been very helpful either. All of my blood work is normal except a high ASOT of 800. I am not aware of having suffered a strep throat so I do not understand the ASOT being off the chart. About 8 years ago I presented with a painful whole body rash and my ASOT was found to be 800 then. I was treated for strep throat with anti-biotics even though I had no symptoms and also prednisolone which made the rash go away. I can't help thinking that my joints issue is related to the ASOT level. I have seen two rheumatologists and an orthapaedic consultant but to date have failed to received effective treatment. Please help. The joint tenderness is constant throughout the day. I hurts more when I apply certain pressures or standing in a certain postion with my body weight. Please help.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. David replied 3 years ago.

Dr. David :

This is Dr. David

Dr. David :

the pain around the elbow area could be a trigger point for fibromyalgia.

Dr. David :

I'm sure your rheumatology doctors have tested for autoimmune diseases

Dr. David :

you need to make sure you have been tested for lyme disease and for rheumatoid arthritis as well.

Dr. David :

AST of 800 is very high.

Dr. David :

you need more testing to check for hepatitis inflammation as well.

Dr. David :

hello?

JACUSTOMER-o1401wzo- :

Thanks Doctor. Should the ASO return to normal levels after a while? I never recalled having a strep throat - is it possible to have a strep throat but not feel symptoms?

Dr. David :

the ASOT liver enzyme should return to normal.

Dr. David :

but high ASOT levels like that is a sign of liver inflammation or hepatitis.

Dr. David :

so you need a full liver check for hepatitis viral infection.

Dr. David :

and other causes of liver inflammation

Dr. David :

you need a liver ultrasound or liver MRI scan.

Dr. David :

hello?

JACUSTOMER-o1401wzo- :

Is it possible to scan you a copy of my blood test results for you to take a look at? Of the testing that you mentioned above, it's possible I may have had some of the tests already. However I have not had an MRI.

Dr. David :

yes,

Dr. David :

if you have a pdf version of your lab report scanned in or a word document you can upload here.

Dr. David :

here are instructions

Dr. David :

type a word in the textbox and highlight it

then select the "chain" icon above the textbox or the paper clip icon to upload a jpg

this opens a window where you can click next to the text box to select the jpg or pdf file on your computer to upload into JustAnswer

JACUSTOMER-o1401wzo- :

Doctor, is it possible that I could sign out of the chat for now and send you the test results tomorrow as I don't have them to hand right now?

Dr. David :

that is fine.

Dr. David :

you can come back when you have the reports scanned into the computer.

Dr. David :

let me know when you have more info or questions for me.

JACUSTOMER-o1401wzo- :

much appreciated. should I just sign off the session. I don't want to lose this thread?

Dr. David :

you can always access this threat through the link in your email from JustAnswer

Dr. David :

you don't need to sign off.

Dr. David :

just come back to the email link when you are ready.

Dr. David :

if I don't respond right away, I might be asleep or away from my computer

Dr. David :

I will get back to you as soon as I sign back on.

Dr. David :

I am in the USA.

Dr. David :

so different time zones.