Q: My wife is 26 years old and she has pain in her in leg and knee joints. As we consulted a rheumatologist, after physical inspection he told that it is in initial stage, then he suggested taking Salazopyrin EN tables (sulfasalazine USP) in course of two every day for one week and doubling on every two weeks. But if she takes those tablets then she is getting fever. Mean time doctor suggested taking pain killer (Oruvail). Please can suggest what type of rheumatics is and what medication for this is. Now days her pain is increasing Please advise.

A:It is difficult to give a diagnosis based upon the information that you have provided. However, I would strongly recommend that her condition is re-evaluated especially in view of fever. Pain and swellings in the ankle joint associated with fever is often seen in a condition called Lofgrens syndrome (a form of acute sarcoidosis). The diagnosis can be easily confirmed by doing an x-ray chest, but contrast enhanced CT scan of the chest to see the mediastinal lymph nodes, is usually diagnostic of this disease. This is just one of the suggestions. She may require some more studies and investigations to get to the proper diagnosis. Treatment can ONLY be finalised once an accurate diagnosis is made.