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Dr. K.
Dr. K., Board Certified MD
Category: Medical
Satisfied Customers: 4520
Experience:  Board certified with experience in primary care.
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I would like a differential diagnosis based on the following

Resolved Question:

I would like a differential diagnosis based on the following medical history/symptoms and family history.
Upto age 11 no problems, asthma presented at age 11
Age 13 joint pains presented specifically knees going swollen, red hot and tender.
age 13 - kept falling playing sports, joints locking, grinding lots of crepitus.
Age 13/14 - identified leg lenth discrepancy, hip misaligned (no treatment given other than ankle and knee braces and orthotics)
Age 13-16 - same problems but started to present in wrists, shoulders, elbows, ankles. Given painkillers
Age 19 - ligament reconstruction in right wrist due to chronic synovitis, tear of triangulofibrocartilage grade 3 etc.
Age 20 - diagnosed fibromyalgia
Between these years - asthma getting progressively worse lots of resus admissions, struggling to control it.
Age 23- diagnosed dysautonomia - pots and tachycardia
Other health conditions diagnosed in between these dates.
Progressively getting worse, developing foot drop, loss of deep tendon reflexes in knee and ankles, pins and needles in hands and feet, burning pain in hands and feet and still swollen, red and hot knees. Lots of dizziness, nausea, constantly dehydrated, fall over and faint alot, hypotension.
Diagnosed overall with:
Dysautnomia - Postural Orthostatic Tachycardia
Fibromyalgia
Paroxysmal Tachycardia
Migraine and Cluster Headache
Trigeminal Neuralgia
Dyslexia
Congenital Limb Deformity - Leg length discrepancy and twisted hips
Asthma
Family history -
Grandma - COPD,Asthma,osteoartritis
Grandfather - MS
Mother - skin Cancer
Father - Asthma
My questions is - do you think my diagnoses make sense? I have felt my gp rushed into diagnosing fibromyalgia and putting everything along with it because i was in pain. But I had pain before this diagnosis, fibromyalgia is not progressive, should not cause foot drop etc.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. K. replied 2 years ago.
Dr. K. :

Hello, this is Dr K.. Answers are not medical advice and do not constitute a doctor/patient relationship. I look forward to helping you today.

Dr. K. :

1. Rheumatoid arthritis

Dr. K. :

2. Multiple sclerosis

Dr. K. :

3. Charcot marie tooth disease

Dr. K. :

4. Inherited types of muscular dystrophy

Dr. K. :

5. LUpus or other connective tissue disease

Dr. K. :

Really though you need a comprehensive consultation at a large referral center, here in the US I usually recommend St Judes or Mayo Clinic

Dr. K. :

You may need to go overseas to get a diagnosis

Customer:

Hi,

Customer:

Hi, Thanks for your reply. I have had tests for somethings. I have had a rheumatoid factor test twice which was not positive, C reactive protein again not positive, ANA assay which is always speckled but my doctors seem to ignore that.

Customer:

  • Hi. I have had the following tests:

Customer: My apologies my messages have been sending mid typing. I have had the tests already mentioned I had an MRI but this was for migraines and did not show anything. I have had no testing that for nerve conduction apart from someone using a monofilament an finding loss of sensation but no EMG etc I am thinking of looking for a private doctor in the Uk would a neurologist be my best bet? If I can't then I may have to plan a holiday to the states and the mayo clinic as I have heard very good things about it. I realise you are not forming a doctor patient relationship, but can I ask does fibromyalgia should a likely diagnosis? I fear it was rushed into because I had pain in my arms, legs, mainly hips and shoulders and although the NHS in the uk is great they do not want to do tests due to cost. As before I appreciate your help and advice as to whom I may be best seeing. Thanks
Dr. K. :

Speckled ana indicates connective tissue disease

Dr. K. :

It indicates production of autoantibodies

Dr. K. :
Dr. K. :

Yes either a rheumatologist or neurologist

Dr. K. :

No, fibromyalgia is just a catch all for pain

Customer: So if the ANA is speckled but the dsdna and other tests are negative does this rule them out? Thanks
Dr. K. :

No not at all

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