I had an appointment at the Rheumatology department today, to get a diagnosis on my joint problems.
The exam lasted an entire hour. He first asked me in every possible way where the pain was, what it was like, how often it appeared, how long it lasts and what helps. He also asked when it started and about stress, sleep, energy level, work, and similar things. He also asked about other conditions I have or have had in the past, and what medications I’m on. In addition to this, he asked which painkillers I’ve tried and how well they work.
Then he checked trigger points and found 10 positive and 2 unclear. There are also some that are uncharacteristic for rheumatic conditions. He then checked the mobility in my fingers, hands, elbows, shoulders, and back.
The then checked the results of the blood tests I had last week and my blood pressure.
All the blood tests were as they should be. They took four vials: haemoglobin percentage, infection test, a test for rheumatic indicators and one more that I didn’t see. My blood pressure was 100/80, and no one can complain about that.
I’ve taken blood tests earlier that have shown that I have all the vitamins I need.
According to the doctor, it was surprising that I have such a serious osteoarthritis in my knees at such a young age. I am overweight, but not enough to cause that kind of damage (his words). I haven’t had any major stress on them either. As I told him, it’s more the fact that I’ve been too inactive.
He also said that my positive disposition causes me to have less pain than I otherwise would have had.
He said that I’ve got arthralgia and a vague pain condition that’s most consistent with fibromyalgia. But I don’t have enough trigger points for him to diagnose fibromyalgia at the moment. I’ve got 10 positive and 2 unclear trigger points out of 18, and you need at least 11 positive points. I also don’t have any of the psychological symptoms of fibromyalgia. In addition to all this, he said I’m very flexible (not fully hypermobile). This leads to the joints being moved further, and this can cause pain. (My Chiropractor says I cause small wounds in my joints when I move too fast.)
He’s referred me to Radiology to get X-rays of my hands, wrists, elbows, shoulders, feet and ankles. I’m supposed to call for a new appointment when the X-rays are done. If nothing shows up on the X-rays, he’ll probably diagnose me with fibromyalgia anyway.
He said that the treatment most often consists of directed physiotherapy, which my regular doctor can refer me to if needed. Tricyclic anti-depressants are out of the question because of my disposition. He mentioned Tramadol as an alternative painkiller.
He gave me some papers with information on fibromyalgia before I left, and now I’m back at work.