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I been having some issues with my joints in my knees, elbows, and fingers. Also, weakness in my bones and muscle ache. I'm thinking this could be some kind of arthritis or other autoimmune disease. Based on my research. Although, I'm not 100% sure. It's been progressing, started in my knees, then my elbows, and fingers, and becoming more severe.
I would think the doctor would check out my body parts, blood test and x-rays based on my research.
Would an Internist be able to make a diagnose based on these test?
I been having some issues with my joints in my knees, elbows, and fingers. Also, weakness in my bones and muscle ache. I'm thinking this could be some kind of arthritis or other autoimmune disease. Based on my research. Although, I'm not 100% sure. It's been progressing, started in my knees, then my elbows, and fingers, and becoming more severe.
I would think the doctor would check out my body parts, blood test and x-rays based on my research.
Would an Internist be able to make a diagnose based on these test?
Or should I go straight to the rheumatologist?
I'd probably start with my PCP. There are a number of systemic things that could create these symptoms. Even something straightforward like a nutritional deficiency an OTC supplement could fix. Depending on your insurance provider you might need a referral from a PCP in order to see a specialist anyway. Consider that if you went straight to a rheumatologist they might order the same routine systemic diagnostics as the PCP but they might not. If the problem wasn't something the rheumatologist could find or even treat, they'd send you back to the PCP. The specialist's fees might be higher too.
Last edited by Parnassia; 08-16-2020 at 11:41 PM..
OP follow the above posters advice. If you jump doctors you could have insurance problems. Our insurance co. requires us to go to the primary doc first for a referral. Otherwise we may have to pay out of pocket.
See what your insurance allows. With Standard Medicare/Medigap, self-referral to a specialist is allowed as long as the specialist accepts Medicare assignments. With Medicare Advantage and similar "network" or managed care plans, it may not be possible. Medicaid usually requires the the PCP to be the "gatekeeper".
Go to your PCP and after a physical, he or she will most likely ask for a blood panel which includes CRP and ANA. Depending on the results they may refer you to a rheumatologist.
I been having some issues with my joints in my knees, elbows, and fingers. Also, weakness in my bones and muscle ache. ...
When you hear hoof beats on the road coming 'round the bend, it'll probably turn out to be a horse and not a zebra.
By definition, an arthritis is a hot, red, swollen joint. An examiner can see that's it's abnormal....An arthralgia is a joint that hurts but looks ok.
Among the various autoimmune diseases that cause arthritis, the diagnosis is made based on history and physical exam. It's a clinical diagnosis, as opposed to things like anemia or diabetes that are laboratory diagnoses-- diagnosis based on the lab test.....For the Rheumatoid Diseases, the labs merely lend support to the diagnosis, or aid in following the effects of treatment.
In short, start with the PCP.-- most likely it's a simple arthralgia from over-use or degenerative arthritis, but could also be something else-- like a neurological or hormonal problem, for instance. The PCP should have a wider POV and be less likely to miss something.
Our Medicare Part B and supplemental insurance (AARP, United Healthcare) does not require a referral so we always skip our PCP and go directly to specialists
Our Medicare Part B and supplemental insurance (AARP, United Healthcare) does not require a referral so we always skip our PCP and go directly to specialists
Why waste a specialist's time for something that has not been diagnosed and may not require the specialist you think - or any specialist at all? Years ago I had a step infection in my joints. I was sure I had RA (runs in my family). Nope- strep. A Z-pack took care of it.
Your regular physician will have to refer you to a rheumatologist. And I warn you that that specialty is especially in demand. Expect it to take quite awhile to be seen on your initial visit.
Arthritis is not something to fool around with. We have a friend that didn't deal with her rheumatoid arthritis and she's past being helped very much.
My wife has terrible arthritis, and she's dealing with it. Unfortunately, a knee replacement and major shoulder surgery has been required. She needs knee replacement on her "good" knee and two mid foot fusions. She also is a pain management patient, and has to be seen monthly.
Now you can get Volteran gel and lidocaine lotion over the counter. She suggests you consider using both anywhere it hurts for now.
Why waste a specialist's time for something that has not been diagnosed and may not require the specialist you think - or any specialist at all? Years ago I had a step infection in my joints. I was sure I had RA (runs in my family). Nope- strep. A Z-pack took care of it.
I've got over 50 year medical and pharmaceutical training. MrsM has the same. I know which Drs to go to and my PCP agrees with us 100%
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