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Pain Management

Metal Pins and Physical Pain

04/20/2007

Question:

Good day! I have a brother-in-law who is now suffering from a severe pain in his right leg, from his knee up to his thigh. He underwent a surgery 11 years ago due to a car accident. He has a nail in his right leg. And now, when we go to a doctor, he goes through testing. According to the doctors, they cannot diagnose the cause of that pain. It was just the laboratory exam that resulted the CRP as 12+ and they conclude that it is infection but they cannot say what it really it is. They prescribed an antibiotic and pain reliever but nothing has happened. The pain is more severe and it usually occurred at night time. What can you say about this? What maybe his disease?

Answer:

An elevated CRP is usually an indicator of inflammation, including infection or abscess. However, it is not diagnostic of the problem. The fact that your brother in-law has pain that is worse at night time suggests the possibility of an abscess, however there may be other causes for the pain. Did he have an X-ray or MRI studies? Does he have low back pain and did he have an MRI of the lower spine? Did he see a specialist such as a rheumatologist, neurologist, pain management physician and an infectious disease doctor? If he is just seeing his primary care physician, it is time to move to the next step and see all the above specialist and preferably at a tertiary referral center.

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Response by:

Salim M Hayek, MD, PhD Salim M Hayek, MD, PhD
Associate Professor of Anesthesiology & Perioperative Medicine
School of Medicine
Case Western Reserve University