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Ask Dr. Tarek Your Own Question
Dr. Tarek
Dr. Tarek, Doctor
Category: Health
Satisfied Customers: 52
Experience:  M.B. B. Ch. , Pass in FIRST PART OF Medical Council of Canada Qualifying Exam. MCCQE-1
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Resolved Question:

Submitted: 8 years ago.
Category: Health
Expert:  Dr. Tarek replied 8 years ago.

Is the joint pain alternating between your joints or is it fixed to one joint.

Which joint(s) is \ are affected?

Customer: replied 8 years ago.
all joints
Expert:  Dr. Tarek replied 8 years ago.
Do you feel a burning sensation during micturation?
Customer: replied 8 years ago.
if that is urinating no but it feels like something sqeesing my bladder when done
Expert:  Dr. Tarek replied 8 years ago.

I believe that you need to get a Urinalysis done for crystals and urine precipitates. Moreover, a culture and sensitivity is needed from your urine.

It sounds like you are having a urinary tract infection (UTI) -the "smelly urine",, causing bacteremia (bacteria in the blood) and that is what is causing the fever and the chills.

As the joint pain it may be a gonococcal urethritis that is causing the joint pain and the UTI...

Gonococci need specific antibiotics and not usually eradicated by conventional antibiotics.

Customer: replied 8 years ago.
could they not find this with all the bloodwork they did at hospital
Expert:  Dr. Tarek replied 8 years ago.

As far as my knowledge : burning smelly urine = UTI

: Fever and Night Sweats = Bacteremia


The joint pains are propably due to deposited crystals or due to Gonococcal infection, or it may simply be assosiated joint pain due to any other reason.

Customer: replied 8 years ago.
my urine does not burn
Expert:  Dr. Tarek replied 8 years ago.

Did the smelly urine and the joint pain occur exactly at the same time...

Have there been any abscesses anywhere in your body...?


Customer: replied 8 years ago.
i had a small boil on my left breast and no the joint pain and joint pain started at different times
Expert:  Dr. Tarek replied 8 years ago.
Please clarify "... and no the joint pain and joint pain started at different times..."
Customer: replied 8 years ago.
sorry urine smell started later
Expert:  Dr. Tarek replied 8 years ago.
please give me some time...
Customer: replied 8 years ago.
Expert:  Dr. Tarek replied 8 years ago.
is it convenient to you if we have a chat please?
Customer: replied 8 years ago.
yes but i am a slow typer
Expert:  Dr. Tarek replied 8 years ago.

No problem at all... Take all the time you need.

I am concerned that you are in pain and am sorry for that.

Well it seems to me that your breast abscess (boil) can be the cause of the fever and chills (bacteremia).

But i have some questions that i want you to answer at your convenience and i shall read them and get to you later.

1) When were you absolutely free and not having any complaints?

2) What started first and how did it start? (please mind the chronological order of the complaints)

3) Was it associated with any activity or anything at all?

4) In a scale from 0-10 describe both the joint pain and the bladder pain you feel after urinating...

5) What relieves this pain and what aggrevates it (for both of them)?

6) Are there any other medical issues at all?

7) Are you taking treatment for anything?

8) Are you diabetic, hypertensive or diagnosed with any disease?

9) Is this the first time you experience such a complaint?

10 ) What are the investigations that you underwent in the hospital?

Thank you for your time and I hope I can reach to deliver you some useful information.

Customer: replied 8 years ago.
i have been in pain for about 5 years from fibro but it has gotten worse over the years since i was diagnosed . my feet burning started a couple of months ago. my big toe joint and the toe hurts really bad - about a 8.the rest of my joint pain is about 6-1/2 to a 7 and i dont have to do anything for it to hurt i have joint pain 24/7. i take plaqinel for the fibro and pain meds when i can convince the dr. i am in really bad pain. i have high blood pressure and take micardis for this. i have an under active thyroid and take meds for it also. the bladder thing has been going on about 2-1/2 weeks. and i have never really had any problems with my bladder before this. i have had lower back surgery that didn't help me. i am not a diabetic as far as i know. as for the fevers they occur mostly at night, i will be so cold i will start to shake for 10 or 15 minutes then i will start to sweat so bad it just runs in my eyes and down my face and neck and the rest of my body. i know i sound like a hypocondreact but i am the soul caregiver for my mother who is disable and my husband who has parkinsons. i am also raising a 7 and 11 year old. i mostly work through the pain but this time i can't. they did ekg and blood work in the hospital and could not find anything.i hope this helps if you need to know anything else please ,,,,ask.
Customer: replied 8 years ago.
hello i am still waiting for an answer
Expert:  Dr. Tarek replied 8 years ago.

Yes, I am still trying to figure out things. I am doing my readings and hopefully will get to you.

Thank you for your patience.

Expert:  Dr. Tarek replied 8 years ago.

The best I have reached is that the abscess you had in your breast is acting as a septic focus showering bacteria into the blood stream that is causing you the fever and chills.

As for the joints pain I believe that it is due to a fibromyalgia exacerbation.

You may need to consult your doctor about having both Micardis and Plaquenil for the former may alter the effects of some drugs.

As for Plaquenil, being a HYDROXYCHLOROQUINE you will need to do an Ophthalmologic check up (usually with an Electro Retino Gram ERG) done.

I very much understand your position and that you are the caregiver of a whole family. It must be very difficult keeping on with all these responsibilities. But I have the hope things will turn to be better.

Honestly, I have searched the medical websites, checked through my books to help find a clear explanation but was not able till this moment. I will not give up though. Neither should you! For "every disease has a cure" and I will keep searching for the diagnosis behind your condition.

Expert:  Dr. Tarek replied 8 years ago.

May you give me more details about your joint pain?

What is the distribution of the joints affected? (your vertebral colunm or the ankles, knees, elbows and shoulders?) (the small - finger joints- /big -knee or elbow- joints)

Are you having a red or painful eye?

I am questioning a diagnosis of Reiter's disease here.

Customer: replied 8 years ago.
yes all of the above.all of spine all the way into my neck and shoulders. my knee and elbow joints i dont know if they are any bigger but they hurt like the finger joints hurt so bad sometimes i have trouble cooking for us and i cant open a jar anymore. my eyes are always like i have an allergy to something and i was always an outdoor person.
Expert:  Dr. Tarek replied 8 years ago.

I am sorry to hear this.

Please seek a medical advise for I believe you are having Reiter's disease.

Reiter's disease (or syndrome) is composed of:

-Urethritis: inflammation of the urethra (the passage through which the bladder empties)

-Conjunctivitis: inflammation of the outer transparent (white) coat of the eye [that might be the explaination to what you are saying "my eyes are always like i have an allergy to something"]

-Arthritis: which is inflammation of the joints.[[However, Reiters only causes inflammation of one or a few joints, the extensive involvement of the joints in your case may be due to the fibromyalgia or other rheumatic disease]].

Moreover, Reiter can cause something called "Plantar Fasciitis" which is inflammation of the plantar fascia a tissue present in the sole of our feet. This may explain what you are saying "Bottom of my feet burning".


I believe this is the case then that we are facing here, and I do recommend a visit to your doctor. It is an indication for you to start regaining your health.

I have tried very hard to be helpful. I wish you get better soon. And hopefully you will, for I see a strong person inside you who will not just give in.

Best wishes.



Please keep me updated with what your doctor says or concludes.

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