Joint, Internal Medicine FAQ - Page 8

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Is Daily Use of Celecoxib Effective for Managing Ankylosing Spondylitis?

Is this considered an effective treatment? My son is currently 18 years old and started showing symptoms of ankylosing spondylitis two years ago, with a diagnosis made one year ago. I have the following questions: 1) For the past six months, my son has been taking two capsules ...


Dr. Gao Jiankai Reply:
Hello, thank you for your inquiry. Here is my response summarized as follows: 1) My son has been taking 2 capsules of Celecoxib (200 mg) daily for the past six months, which has kept his CRP around 0.3 mg/dL and ESR around 12, and he has not experienced any pain (previously he ...

[Read More] Is Daily Use of Celecoxib Effective for Managing Ankylosing Spondylitis?


Understanding Sacroiliitis Levels in Ankylosing Spondylitis Diagnosis

What grade of sacroiliitis does it belong to? Dear Dr. Tseng, My son is 19 years old. A year and a half ago, he started experiencing pain in the sacroiliac joint, and recently, through MRI and other examinations, he has been diagnosed with ankylosing spondylitis. Below is the te...


Dr. Gao Jiankai Reply:
Hello, thank you for your inquiry. I am not Dr. Tseng, so if you are looking for Dr. Tseng, please choose the corresponding hospital and department. The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, is here to assist you.

[Read More] Understanding Sacroiliitis Levels in Ankylosing Spondylitis Diagnosis


Should We Change Medications for Ankylosing Spondylitis Management?

Should the medication be changed? Hello Doctor: My child (born June 2003, currently 18 years and 6 months old) developed ankylosing spondylitis in June 2019 (symptoms only included sacroiliac joint pain, with no morning stiffness). However, he was only diagnosed with ankylosing s...


Dr. Zeng Guosen Reply:
1. At that time, the patient was unable to stabilize their condition with the current medication, so it may be worth trying the new medication recently; if it proves ineffective, we can switch back. 2. It may be worth trying the new medication recently; if it proves ineffective, ...

[Read More] Should We Change Medications for Ankylosing Spondylitis Management?


Managing Rheumatic Pain During Labor: Natural vs. Cesarean Delivery

Please consult the physician again? Hello, doctor. I apologize for the confusion in my previous message. The pain I mentioned refers to the recurrent pain caused by rheumatism, such as swelling and pain in the knee joints, thigh joints, and arms. The pain persists even at rest an...


Dr. Gao Jiankai Reply:
Hello, the previous response still applies to your current question. Even if joint pain worsens as you approach delivery, there are medications available to help manage the symptoms, which you can discuss with your rheumatologist. If you experience joint pain during labor, you ca...

[Read More] Managing Rheumatic Pain During Labor: Natural vs. Cesarean Delivery


Managing Chronic Health Issues Before Military Service: A Guide

Pre-enlistment Consultation Hello, doctor. I have been seeing various doctors since middle school. My symptoms include pain around the joints at night, sometimes accompanied by redness and swelling, headaches, dizziness, and low-grade fevers (around 37 to 37.9 degrees Celsius, wh...


Dr. Gao Jiankai Reply:
Hello, thank you for your inquiry. I recommend discussing your situation with your attending physician to assess whether you meet the criteria for a change in position. If you do, please ask them to issue a medical certificate, which you can then use to apply for a military re-ex...

[Read More] Managing Chronic Health Issues Before Military Service: A Guide


Managing Childbirth Challenges in Women with Ankylosing Spondylitis

Issues related to childbirth in women with ankylosing spondylitis? Hello, Doctor. I started experiencing severe joint swelling and pain around the age of 13, and now at 31, the locations and timing of the pain have changed with age. I only began seeking medical attention in adult...


Dr. Gao Jiankai Reply:
Hello, thank you for your question. Here are my responses: 1) Due to the frequent pain during flare-ups, which can make movement difficult, is it possible to have a smooth delivery if the condition flares up during natural childbirth? --> In principle, flare-ups of ankylosin...

[Read More] Managing Childbirth Challenges in Women with Ankylosing Spondylitis


Understanding ANA Levels: Key Insights for Autoimmune Concerns

Autoimmunity Hello Doctor, I went to see a dermatologist for hair loss and had a blood test, which showed an ANA value of 80, negative. The doctor told me to see a rheumatologist if I experience joint pain or related issues. I would like to ask: 1. Are there any methods to preven...


Dr. Gao Jiankai Reply:
Hello, thank you for your questions. Here are my responses: 1. Is there any way to prevent ANA levels from rising? --> A positive ANA is part of an individual's constitution and generally does not change significantly. However, slight variations may occur due to differen...

[Read More] Understanding ANA Levels: Key Insights for Autoimmune Concerns


Understanding Gout: Duration, Symptoms, and Treatment Insights

Please ask some questions about gout? Hello, Doctor. My mother suddenly has difficulty walking on her right leg, and her right knee is very swollen, hot, and painful, although there are no visible signs of redness. After being hospitalized, it was found that there were bacteria i...


Dr. Gao Jiankai Reply:
Hello, thank you for your question. Here are my responses to your inquiries: 1. Can gout symptoms last this long? I found online that gout usually comes and goes quickly, but my mother's symptoms have persisted for over a month. --> In terms of gout, this duration is ind...

[Read More] Understanding Gout: Duration, Symptoms, and Treatment Insights


Understanding Enlarged Lymph Nodes with Necrosis: Causes and Treatments

I would like to inquire about lymphadenopathy associated with necrosis? Hello Doctor: I have had a history of epilepsy since childhood, but it has been well controlled. At 36, I experienced ovarian decline, and by 37, I had completely gone through menopause. I have had a persiste...


Dr. Gao Jiankai Reply:
Hello, thank you for your question. Here is my response: Question: Could this be Kikuchi disease? Is necrosis very serious? Is surgery necessary, or are there other more conservative treatment options? Response: Kikuchi disease requires a lymph node biopsy. Necrosis is merely ...

[Read More] Understanding Enlarged Lymph Nodes with Necrosis: Causes and Treatments


Understanding Sjögren's Syndrome: Symptoms, Diagnosis, and Management

Sjögren's syndrome is an autoimmune disease? Hello Doctor, I had an appointment in October and experienced symptoms of dryness. I consulted a rheumatologist, and all my blood tests came back normal, but my condition shows tendencies towards lupus erythematosus. However, I ha...


Dr. Gao Jiankai Reply:
Hello, thank you for your question. There are many causes of dry symptoms, and Sjögren's syndrome is just one of them. While blood tests show "lupus-like phenomena," there is no definitive evidence of Sjögren's syndrome. Typically, we recommend follow-up visit...

[Read More] Understanding Sjögren's Syndrome: Symptoms, Diagnosis, and Management


Understanding Ankylosing Spondylitis: Managing Inflammation and Treatment Options

Ankylosing spondylitis has fluctuating levels of inflammation markers? Doctor: A young male, 18 years old, was diagnosed with ankylosing spondylitis at the end of 2020 and started taking Celebrex (200 mg). Below are the CRP (mg/dL) / ESR (mm/hr) and medication records: 2020/11/...


Dr. Zeng Guosen Reply:
1. BNT may lead to instability in certain immune inflammatory diseases. 2. If the ESR is significantly elevated but there are no symptoms, it is advisable to monitor the situation; further investigation should be conducted if abnormalities arise. 3. Disease control includes: ...

[Read More] Understanding Ankylosing Spondylitis: Managing Inflammation and Treatment Options


Can Immunosuppressants Cause Low White Blood Cell Count in Myasthenia Gravis?

Immunosuppressants Hello Doctor, my mother is a patient with myasthenia gravis and has been suffering from it for over 10 years. This year, she started taking one immunosuppressant daily. Two months ago, she had an infection in her artificial joint and is currently being treated ...


Dr. Gao Jiankai Reply:
Hello, thank you for your question. Azathioprine, an immunosuppressant, can indeed lead to leukopenia, and the severity varies from person to person. In elderly patients, the bone marrow is often more aged, and combined with fluctuations in their medical condition, even a low dos...

[Read More] Can Immunosuppressants Cause Low White Blood Cell Count in Myasthenia Gravis?


Understanding Prolonged Pain After BNT Vaccination: A Patient's Journey

Discomfort after receiving the BNT vaccine? Hello Dr. Hong, I received my first dose of the BNT vaccine on June 20 at 15:58, and I began experiencing pain under my left clavicle at 16:08. Twelve hours after the first dose, I developed a fever and redness and swelling at the injec...


Dr. Hong Yuanbin Reply:
Hello, muscle and joint pain after vaccination is quite common. However, if you have been experiencing pain for two months and it is getting worse, it may be necessary to consider that it might not be solely caused by the vaccine and that other underlying conditions could be invo...

[Read More] Understanding Prolonged Pain After BNT Vaccination: A Patient's Journey


Missed the Golden Treatment Window for Rheumatoid Arthritis?

Did rheumatoid arthritis miss the golden period for treatment? Hello, doctor. For the past two to three years, I thought my joint pain was due to aging, but I only learned over a year ago that I have rheumatoid arthritis. Unfortunately, it has already caused damage to my foot joi...


Dr. Zeng Guosen Reply:
Hello, regarding the treatment of rheumatoid arthritis, the earlier the better. The first year after onset, or even the six months prior to the onset, is considered the golden period for treatment. However, as long as a diagnosis is confirmed, it is never too late to pursue aggre...

[Read More] Missed the Golden Treatment Window for Rheumatoid Arthritis?


Understanding Your Immunology Blood Test Results: SSA and SSB Levels Explained

Examination Report The immune blood test report shows normal results, with SSA and SSB levels at 17.15. Are these considered positive? Are they normal?


Dr. Gao Jiankai Reply:
Hello, thank you for your message. The normal range values for SSA and SSB tests may vary slightly between hospitals, so it would be best to include the normal range from your test report for a more accurate assessment. Based on our hospital's reference normal range, your va...

[Read More] Understanding Your Immunology Blood Test Results: SSA and SSB Levels Explained


Joint Pain and Stiffness: When to Seek Further Medical Evaluation

The finger joints are swollen and painful, but the doctor said it is not rheumatoid arthritis? Hello Doctor, since late last year, I have noticed stiffness in my finger joints upon waking up, which was mild at first. Recently, the frequency has increased, and almost every day my ...


Dr. Gao Jiankai Reply:
Hello, thank you for your message. An ANA value of 1:80 falls into a gray area. However, if you continue to experience joint pain and stiffness, along with occasional nighttime pain that disrupts your sleep, I recommend that you visit a rheumatology clinic to discuss your concern...

[Read More] Joint Pain and Stiffness: When to Seek Further Medical Evaluation


Understanding Rheumatoid Arthritis: Eye Symptoms and Immune System Links

Clinical symptoms of rheumatoid arthritis? Hello, Doctor. I started experiencing dryness and pain in my left eye last year. Last month, I suddenly developed scleral inflammation in my right eye. After seeking medical attention, my condition is currently stable. Recently, I underw...


Dr. Zeng Guosen Reply:
Hello, dry eyes and scleritis can be manifestations of rheumatic diseases affecting the eyes. If the rheumatoid factor is positive, it is recommended to consult a rheumatologist for differential diagnosis, as rheumatic diseases do not always present initially with joint symptoms.

[Read More] Understanding Rheumatoid Arthritis: Eye Symptoms and Immune System Links


Concerns About STDs After Potential Exposure: What You Need to Know

Concerned about sexually transmitted infections (STIs)? Hello, Doctor: About four months ago, I met a male friend online and during our encounter, he inserted his finger into my anus while he masturbated and ejaculated (he was wearing a condom; I asked him afterward, and he said ...


Dr. Hong Yuanbin Reply:
Hello, based on your description, acne is usually caused by hot and humid weather leading to folliculitis, which should not be related to sexually transmitted infections. However, the process you described may indeed indicate unsafe sexual behavior. It would be advisable to consi...

[Read More] Concerns About STDs After Potential Exposure: What You Need to Know


Understanding Stiff and Swollen Finger Joints: Causes and Solutions

Stiffness and swelling in the finger joints? Hello Doctor: Last year in late autumn, I noticed stiffness in my finger joints upon waking up, but it was mild, so I didn't pay much attention to it. Recently, however, the frequency has increased, and almost every day my fingers...


Dr. Zeng Guosen Reply:
Hello, experiencing stiffness in the finger joints upon waking, pain in the index finger, swelling in the fingers, positive urine occult blood test, and hair loss should not be ignored, but there is no need to panic. Please seek medical evaluation, as there are many potential cau...

[Read More] Understanding Stiff and Swollen Finger Joints: Causes and Solutions


Understanding Symptoms After Toenail Injury: Fever, Dizziness, and More

After injuring the toenail, a series of symptoms began, primarily persistent low-grade fever and dizziness? Hello, Doctor. At the beginning of last month, while on a business trip and staying at a hotel, I accidentally injured my right big toe by pinching it in the door. There wa...


Dr. Lin Wufu Reply:
Hello! Generally, a nail injury is unlikely to cause a systemic infection (unless the local wound condition is very poor). Your initial symptoms resemble those of a systemic inflammatory response or infection, but typical infections do not usually last for a month. It would be ad...

[Read More] Understanding Symptoms After Toenail Injury: Fever, Dizziness, and More


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