Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.
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Dear Martin,
I wrote before about my girlfriend's leg that you thought might have thrombosis. Now visited the army hospital in Warinchamrab. Unfortunately, my Thai is rudimentary, but I try to paint a picture of how things went.
To begin with, the doctor doubted thrombosis because my girlfriend does not lead a sedentary or lying life and the leg is not extremely thick and therefore did not meet the picture that occurs with thrombosis. Did a blood test anyway, I don't know what the lab did, the doctor later said the blood was "normal" whatever that means?
From all this, the doctor concluded to myositis. It was not clear what that was based on. I do understand that myositis is rare and difficult and complicated to diagnose. So I suppose, given the foregoing, that the basis under this diagnosis is very thin. Because myositis can be serious and difficult to treat, I worry about all this.
For the follow-up, an appointment at the beginning of August with an orthopedic doctor and left with paracetamol and dyclofenac.
Can you give us some tips on how best to proceed.
Yours faithfully,
K.
******
Specifications,
Thrombosis is indeed more common in sedentary occupations, but not only there. A simple determination of D-dimer can help make the diagnosis. It can also be seen on an ultrasound scan of the leg vessels. With a deep vein thrombosis, the leg is often not extremely swollen.
Myositis is difficult to diagnose. A high CK value in the blood is an indication, but a biopsy is needed to make the diagnosis. In addition, myositis is usually present in more muscles at the same time. It's one of the side effects of the Covid injections. To make that diagnosis just goes a long way. Normally it is treated by a rheumatologist. I don't think an orthopedist is the right specialist.
It would of course be useful if I could get the results of the blood test. With a normal rash, myositis is very unlikely.
I can't say more about it because there are no more details.
Sincerely,
Dr. Maarten
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information (see list at the top of the page).