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Friday, November 21, 2014
Arthritis and Rheumatism
sir, I am forty six years old house wife.I have got menstrual ailment for about one year.During my menstrual period i found mild inflammation at my two legs.After menses it would disappear.During this time i have no appetite.But in contarary to this,during my previous menstrual period in january,i detected inflammation at my left foot especially at ankle region only and it still exists without pain. Due to this i consulted a doctor and she conducted four various test including haemoglobin count, RH factor,ESR level and rheumatic test.The test report reveals me that my haemoglobin count is only 8gm and all other tests show normal . The doctor advised me to increase my haemoglobin count.She said that it is this low haemoglobin level that causes inflammation in my foot.So she prescribed a lot of iron tablets and other vitamin tablets for me.I obey her advice for last two weeks.But inflammation still exists without cure.Meanwhile i got my regular menstrual period in february.Today is my third menstrual day and so inflammation raises gradually at my ankle region.I have no extraordinary bleeding and stomach ache.The flow of blood is quite normal. Iam very disappointed.What is the reason for inflammation in my ankle region only?There is no fracture in my foot.I used to stand and walk lot of time rather than sitting on a chair.So , sir, I kindly request you to send remedy for my ailment.I hope that you will send me adequate advice and save me.
This question was forwarded by Gynecology:
The NetWellness site cannot offer specific diagnoses in place of the care that you receive from your physicians. This is especially true given the seemingly complex nature of your situation. That being stated, one place to start with your diagnostic dilemma would be further evaluation of your anemia as demonstrated by your low hemoglobin count. Even though your complaint is of ankle “inflammation,” it is not clear to me whether or not this is truly inflammation, joint pathology, or other. Additionally, it is not clear to me whether or not your ankle complaints are a primary or secondary process.
On the other hand, there is objective evidence of anemia. The source of anemia can be highly variable, including blood loss, poor production, or peripheral destruction of blood cells. The cause of the anemia may or may not be associated with a rheumatic process. By discovering the source of your anemia, your physicians may have a better idea of potential causes of your entire symptom complex.
This is certainly one of many possible approaches to your complaints. Your physicians may take other approaches based on other information that they have derived from their established personal relationship with you.
Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University