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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31633
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have osteoarthritis and fibermyalgia. I have two new

Customer Question

I have osteoarthritis and fibermyalgia. I have two new knees; a new hip; a new shoulder; and a fused back Lumbar 3/4. I am 68 years old and fairly active: teach fencing 4 days a week; fence 1-2 days a week; summer golf 2-3 golf leagues a week.
Question: I have black & blue marks all over my legs. They sometimes spread into larger areas. Besides being ugly - is this anything to worry about?
Submitted: 3 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 3 months ago.

Hello,
I am Dr. Arun and will be helping you today.

Could you please post a photo of black-blue marks.

Customer: replied 3 months ago.
I dont know how. KMB
Expert:  Dr. Arun Phophalia replied 3 months ago.

The black-blue marks are likely to be what is termed as Ecchymoses (bruise). This usually develop with or without noticeable trauma and do not spread into deeper tissues. This can occur due to the structural abnormalities of the small blood vessels called as capillaries, which break even with the slightest of the injury. This can occur due to the age, scurvy, steroid-induced purpura, small vessel vasculitis, and purpura associated with the presence of paraproteins. Aspirin may also be responsible which can increase the bleeding time. The diagnosis is based on the investigations. Though, with the possible exception of a prolonged bleeding time, screening tests are usually normal in patients with bleeding disorders related to vascular abnormalities (ecchymoses / bruising). Taking Vitamin C or eating citrus fruits or fresh juices may help.

The investigations done are;

1) platelet count,

2) bleeding time (BT),

3) prothrombin time (PT),

4) activated partial thromboplastin time (aPTT),

5) thrombin time (TT)

6) peripheral blood smear,

7) platelet aggregation in response to ADP, epinephrine, collagen, and ristocetin;

8) platelet release assays,

9) coagulation factor assays,

10) assessment of factor XIII activity via clot solubility testing

11) Tests of fibrinolysis; measurement of fibrin split products and D-dimer levels.

Your PCP can get them done. An initial screening can be done by the first 5 or 6 tests which would give very definitive clue to the diagnosis.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 3 months ago.

Ecchymoses do not cause any long term consequence are not considered anything serious.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

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Thank you.

Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 3 months ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited and paid for my work.

Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.

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- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.

Thank you.

Expert:  Dr. Arun Phophalia replied 2 months ago.

Best wishes,
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