Should I Trust My Diagnosis or Get a Second Opinion?
I am a 26-year-old female living with limited GPA disease. For the past five years, I have been managing my condition with a regimen that includes prednisone and Azathioprine. Recently, my rheumatologist decided to reduce my maintenance dosage from 5mg to 0mg. Unfortunately, this change did not yield positive results, as I experienced severe joint pain and a flare-up, leading to my return to a 5mg dose. Despite being back on this dosage for about two weeks now, I continue to suffer from intense joint pain, overall bodily weakness, morning numbness in my legs, as well as muscle soreness and stiffness. Additionally, I have noticed the sudden appearance of hard, round hematomas solely on my left leg. These formations are quite large and were bright red on the first day, gradually fading like a bruise over a week. They occur exclusively around the knee area on my lower left leg and are quite painful initially, almost like I’m housing a solid mass inside my leg. My family doctor has suggested that these symptoms could indicate Erythema Nodosum, but the appearance of my bruises leaves me skeptical. Could it be possible that I genuinely have Erythema Nodosum? I’ve included images in the comments showing the bruise on its first day and again as it fades.
Answers (1)
8/2/2025, 3:02:05 PM
OpenHealth AI
It's understandable to feel uncertain about your diagnosis, especially when dealing with a chronic condition like GPA disease and the accompanying symptoms you've described. It's important to trust your instincts; if you feel that your health is not improving or if new symptoms arise, seeking clarification is your right as a patient.
Key Points:
- You are experiencing persistent joint pain, weakness, morning numbness, and the appearance of hematomas.
- You have been recently transitioned off medications with negative results and are back on treatment but still facing symptoms.
- Your doctor's suggestion of Erythema Nodosum is worth evaluating further given your symptoms and concerns.
Explanation:
Erythema Nodosum is typically characterized by painful, red nodules that can feel like deep nodules under the skin, commonly occurring on the legs. It can be associated with various conditions, including infections, medications, and other autoimmune diseases. The hematomas you're describing, especially their sudden appearance and progression, also warrant careful assessment as they may indicate something that needs a closer look.
Next Steps:
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Monitor Symptoms Closely: Keep a detailed record of all your symptoms, including their intensity, duration, triggers, and any new developments. This will help provide a comprehensive overview for your doctor.
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Request Further Evaluation: Consider discussing your symptoms again with your rheumatologist, emphasizing the persistence of your joint pain, weakness, and the hematomas. Ask if further testing is warranted to explore other potential diagnoses, including Erythema Nodosum or other relevant conditions.
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Second Opinion: If you're feeling uncertain about the current management plan or the recent changes in medication, seeking a second opinion from another rheumatologist can be beneficial. It can provide you with reassurance or alternative treatment options.
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Lifestyle Adjustments: While waiting for your next appointment, prioritize self-care. Focus on gentle movement to maintain joint flexibility, manage stress through mindfulness or relaxation techniques, and ensure you are hydrating and nourishing your body adequately to support your overall health.
It's critical to advocate for yourself and seek clarity when you feel your health is not where it should be. You deserve to receive care that addresses all aspects of your health.
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