Pain in both shoulders and right side at the back

[Sweet-love]

Can anybody shed some light on why I get pain like a burning sensation in the liver and then radiating to the right hand of the back and pelvis, had a fibroscan 2 weeks ago results are 272 cap 13.7 kpa nurse said I had fibrosis of the liver, I am not a drinker I eat fairly healthy 51 years old, I am so confused by all of this, just had all the hepatitis and autoimmune blood tests awaiting results. Can anyone offer any advice on the above? Very anxious at the moment.

[AyrshireK]

Hi Sweet-love, obviously you are undergoing further assessment which is good. They need to establish why you have an elevated kPa score and indeed what degree of fibrosis this may represent (different underlying conditions have different bands as to what any given kPa score reflects on the metavir fibrosis scale F0-F4). ALSO, they need to know what your bloods were doing at the time of the scan, I take it you had fasted before hand too. Eating before a fibroscan can falsly inflate the kPa score as can ongoing inflammation (which would be deduced by bloods). Fibroscan can not differentiate between actual fibrous tissue and inflamed tissue - an inflamed liver can present a false high kPa result. (We've had members here score the fabled 75 kPa i.e. as high as it can go but at the same time their liver was madly inflamed, when the inflamation got controlled the kPa result returned to normal or near normal).

An inflamed or enlarged liver can impinge on the Glisson's Capsule surround the organ which can cause twinges of pain - the liver itself having no pain receptors. It can also cause radiating shoulder pain if the phrenic nerve becomes compressed. This is usually just the right shoulder - left shoulder pain can indicate some splenic involvement.

Your CAP score at 272 is within the range of S2 steatosis so up to 66% of the liver has fatty change - this may be another possible reason your liver may be enlarged and causing pain in the surrounding area and radiating.

List all your symptoms for your next consultation. My hubby and I keep a notebook specifically for his clinic appointments and in it prior to each one we make a note of all medications he's currently on with dosages, all symptoms being experienced and a list of all the queries and questions we have and in that way we make sure and get the most out of the minutes available in clinic and don't leave with the niggling "Oh, I wish i'd asked that!"

Hope you get answers from your investigations very soon.

Katie

p.s. my hubby has cirrhosis due to auto immune liver disease, diagnosed 11 years ago next month.

[Sweet-love in reply to AyrshireK]

Katie Thank you for all that advice, that has really helped a lot. Did your husband have inflammation of the liver? I have severe steatosis which I believe is what is causing me the pain, I have also found my hands and feet are always cold and a bit swollen, has your husband had any of these symptoms?

[AyrshireK in reply to Sweet-love]

Severe steatosis would probably mean your liver is rather large so it could be both stretching the glisson's capsule and/or pressing on that phrenic nerve causing the pain.

My hubby must have had symptomless inflammation of his liver at some point in his life but by the time he was diagnosed he already had cirrhosis - his auto immune hepatitis is now deemed burned out so he has no ongoing liver inflammation. We don't know what triggered his AIH - it may have been long term use of a prescribed antibiotic for acne and his condition may be a DILI (Drug induced liver injury). That's often the nature of liver disease, it is silent and not picked up before it is pretty well advanced.

Hubby does tend to feel the cold more readily and yes has cold hands/feet at times. Feet are never swollen ...... that could potentially be a sign of some fluid build up.

Make sure you tell your doctor of all your symptoms.

Katie