Hi doctor,My mother is 57 years old and she is suffering from fever, joint pains and headache. The level of her ESR is very high i.e. 110mm. She is taking the medications from last 10 days but still instead of decreasing; its gradually increasing. Please help!Sonam
HER SYMPTOMS OF FEVER, JOINT PAINS AND ESR >110 SUGGESTS RHEUMATIC DISORDERS. I Would LIKE TO KNOW IF SHE HAS VISUAL COMPLAINTS.ALSO I Would EXAMINE FOR TEMPORAL ARTERY TENDERNESS.IF THESE FINDINGS ARE POSITIVE SHE IS LIKELY TO HAVE GIANT CELL ARTHRITIS FOR WHICH SHE SHOULD BE STARTED ON CORTICOSTEROIDS AND TEMPORAL ARTERY BIOPSY NEEDS TO BE DONE. ANOTHER CLOSELY ASSOCIATED DISEASE IS POLYMYALGIA RHEUMATIC IF SHE IS COMPLAINING OF STIFFNESS OF MUSCLES.HER DETAILED CLINICAL EXAMINATION WILL MAKE THINGS CLEAR WITH INVESTIGATIONS OF COMPLETE BLOOD COUNT, RA FACTOR AND ANA.LAST DIFFERENTIAL DIAGNOSIS OF TUBERCULOSIS ALSO TO BE KEPT AT THE BACK OF MINDTHANKS Chat Doctor.