[39F] With severe wrist pain, sweating, and fatigue

Patient Description

A 39-year-old female has been experiencing sharp and throbbing pain in her wrist for a little over a month. The pain is constant and rated at 10 out of 10 in intensity. There was no preceding injury or accident. Movement exacerbates the pain, and there is swelling underneath the inside below the thumb. The pain started gradually and then became constant. Additionally, the patient has been feeling hot, sweaty, and fatigued for about a week, with sweating severe enough to soak through clothes, especially when moving around or cleaning the house. Fever is also noted during movement. The patient reports stiffness and limited range of motion in the wrist, as well as joint pain and swelling in the ankles and feet, with morning stiffness lasting more than 30 minutes. There are no rashes or skin changes around the affected joints. The patient has a history of Bipolar 1, anxiety and panic disorder, and schizoaffective disorder, diagnosed in 2006. She uses recreational drugs, specifically methamphetamines and opiates. There are no known allergies or adverse reactions to medications, and she is not currently taking any medications. No history of autoimmune diseases, chronic medical conditions like diabetes or heart disease, recent travel, or exposure to infectious diseases.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are several potential explanations for your symptoms. Here are the most serious ones that require immediate attention:

  1. Septic Arthritis: This is a joint infection that can cause severe pain, swelling, and fever. Given your intense wrist pain, swelling, and feverish symptoms, this is a serious condition that needs urgent medical attention. Treatment typically involves antibiotics and sometimes surgical drainage of the infected joint.

  2. Osteomyelitis: This is an infection in the bone, which can cause severe pain, swelling, and fever. It often requires antibiotics and sometimes surgery to remove the infected bone tissue.

  3. Rheumatoid Arthritis: This is an autoimmune condition that can cause joint pain, swelling, and stiffness. Given your symptoms of joint pain in multiple areas and morning stiffness, this could be a possibility. Treatment often involves medications to reduce inflammation and manage symptoms.

  4. Drug-Induced Symptoms: The use of methamphetamines and opiates can lead to various health issues, including severe pain, sweating, and fatigue. These substances can also suppress your immune system, making you more susceptible to infections.

What you can do

  1. Seek Immediate Medical Attention: Given the severity of your symptoms, it is crucial to seek medical help immediately. You should go to the nearest emergency room or urgent care center. If you are unable to get there yourself, please call 911 or have someone take you.

  2. Avoid Further Use of Recreational Drugs: Methamphetamines and opiates can exacerbate your symptoms and complicate your condition. It is important to avoid using these substances and inform your healthcare provider about your usage.

  3. Monitor Your Symptoms: Keep track of any changes in your symptoms, such as increased pain, swelling, or fever. This information will be helpful for healthcare providers in diagnosing and treating your condition.

  4. Stay Hydrated and Rest: While waiting for medical attention, make sure to stay hydrated and rest as much as possible. Avoid any activities that could worsen your symptoms.

Remember, I am not a doctor, and it is essential to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. Your health and safety are the top priority, so please act promptly.

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3 mo ago

People Also Ask

What are the symptoms of septic arthritis and how is it treated?

Septic arthritis symptoms include severe joint pain, swelling, redness, and fever. It is treated with antibiotics and sometimes surgical drainage of the infected joint to prevent joint damage.

How can drug use affect joint pain and overall health?

Drug use, particularly methamphetamines and opiates, can exacerbate joint pain, cause sweating, fatigue, and suppress the immune system, increasing susceptibility to infections and complicating existing health conditions.

What are the common signs of rheumatoid arthritis?

Common signs of rheumatoid arthritis include joint pain, swelling, stiffness (especially in the morning), and reduced range of motion. It often affects multiple joints and can lead to chronic pain and joint damage if untreated.

Why is it important to seek immediate medical attention for severe joint pain and fever?

Severe joint pain and fever can indicate serious conditions like septic arthritis or osteomyelitis, which require urgent medical treatment to prevent complications and preserve joint function. Immediate medical attention ensures proper diagnosis and timely intervention.

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