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Not sure what is wrong

I'm a 41 year old male and about 4 months ago, over a weekend, both of my shoulders started hurting. I couldn't wash my hair, lift a cup of coffee or drive very easily. I went to my GP and he sent me to a rheumatologist. I did a bunch of blood work and she looked at my joints but in the meantime she thought I had viral arthritis. I didn't really show any outward signs of inflamation and I was still pretty mobile (no stiffness, no redness or swelling) She told me to just take advil and come back in a month. I've gone back and forth about 4 times now and had a lot of bloodwork but I don't know what is going on. She says she doesn't think I have RA or lupus (or lyme, sjorgens and a few other things she tested me for) My multiple bloodwork labs said I had ANA titer anywhere from 1:80 to 1:320 speckled and an elevated SER. I do have hypothyroidism and have been taking synthroid for about 10 years and on two of the three tests my TSH levels were high. Everything else seemed ok. I am definitely getting worse and worse... it used to be just my shoulders but now it's my knees and hips and elbows too. Luckily my hands and feet still seem to be ok. Also, all of my joints pop and crackle now. I can't go 5 minutes without something cracking a little. Does anyone know what this might be? I see a different rheumatologist this week to get a second opinion but I've been in pain for 4 months now and am hitting depression levels of pain. Thank you.

  1. Hi Jacobr. I think you have something autoimmune. Your Rheumatologist just isn't ready to name it. I remembered my ANA was speckled, and knew that was important. I couldn't remember what it indicated since I have both RA and lupus, so I looked it up. See below:

    Speckled—associated with SLE, Sjögren syndrome,scleroderma, polymyositis, rheumatoid arthritis, and mixed connective tissue disease.

    Maybe give that Rheumatologist one more shot and ask what a speckle pattern ANA means and if you can make an RA or lupus (etc) diagnosis without the specific test being positive on the bloodwork. Some docs won't make a diagnosis without bloodwork being positve in all places. You need to know what kind of doctor you are dealing with. If the doctor doesn't give diagnosis or treat without all the bloodwork being positive, you may want to look for a second opinion. My first Rheumatologist wouldn't do it and I could barely walk or stand up by myself. So glad I didn't stick with him.

    There may be another reason they are holding out. Asking questions like that can open lines of communication and give you insight.

    Thyroid could be Hashimoto's thyroiditis. Goes with my lupus and RA too. You could ask about that with Rheumatologist or the doc that treats your thyroid.

    It took 7 years for all of my bloodwork to turn positive. Patience and persistence is key.

    Good luck.


    1. Thank you for your reply! I am seeing my rheumatologist again in a week and I have an appointment with a second one to get another opinion. It takes so long to see a Dr these days I had already made that second appointment a few weeks ago. I will be more insistent and persistent with my questioning of my results. 4 months has been pretty bad, I can't imagine going 7 years. I know my symptoms aren't as bad as some others have listed here and I am thankful for that so far. But, things seem to be getting worse and not better and everything I've read says to get checked out early to avoid damage later.Thank you again for your reply and I hope you are leading a better life after diagnosis.

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