Question
I am a thirty year old woman who started having bilateral joint pain in my hips at the age of 12. After receiving several different opinions from Orthepaedic Surgeons of tendonitis, bursitis etc, going through countless hours of physical therapy, trying many pain medications, and joint injections there has been no real relief. The pain is there everyday and now there is pain bilaterally in shoulders, hands, feet, knees, sometimes elbows, neck and many other joints. The other piece to this puzzle is a hereditary immune disease. I have common variable immunodefiency involving both IGG and IGA levels. I do take 35 grams of IVIG once every four weeks. I have had various physicians run lab tests trying to diagnose Rheumatiod Arthritis. All though, all of the tests show no indication of the disease. I am at a ropes end with the severe pain that I endure through everyday. Many times not even being able to sit up, walk or have any movement whatsoever. What are my chances of having some sort of inflammatory or auto immune arthritis with labs showing everything negative? What is my next step? I do finally have an appointment with a Rheumatologist for later this month but I am afraid he will not find anything as previous history from other specialists. Any specific tests I should ask for besides an ANA, cell death rate or other Rheumatoid factors?
Answer
The visit with the rheumatologist is the next step and likely should have been done much earlier. The diagnosis of arthritis is not made on blood tests but on the history and physical exam. There are many types of arthritis with normal lab tests. Joint pain has been also described with common variable immunodeficiency.
