Q: Five months back I had inflammation in my ankles and pain too. This had developed all of a sudden. Initially I dismissed it thinking that it may be because of 2-3 days of journey as I had been on a holiday. When the problem did not subside even after 3 weeks, I consulted a local doctor who after testing the blood diagnosed it as arthritis as I was ASO titre positive (some 3.80). Since then I am on Penicillin injections, once in 21 days and pain killers in between. Now there is no swelling but I experience regular pains in my knees, the finger joints and a little in the ankles. Do I have arthritis? Am I taking the correct medicine? Now as the swelling has not appeared again, should I continue with the injections?

A:Ankle inflammation along with aches and pains in other joints has 2 possible causes: 1. A viral illness that is usually self limiting. 2. A relatively uncommon condition called Lofgrens syndrome ( a form of acute sarcoidosis) that may need some specific treatment. For accurate diagnosis of the condition you would have to contact a rheumatologist (specialist in diseases of joints - not an orthopaedic surgeon). I must mention that ASLO titre is a test that is not done after the age of 12 years because acute rheumatic fever never starts after the age of 12 years in Indians. ASLO titre rises non-specifically in any inflammatory condition. It should not be considered acute rheumatic fever and does not require to be treated with penicillin.