Osteoarthritis? RA? Lupus? Which is it or is it all?

03/28/09

Peanut

Topics:Joint Pain , Rheumatoid Arthritis Symptoms , Coping With Chronic Pain

In 2005 I had a cervical spine dysectomy with fusion. In 2007 I was told by my orthopedic surgeon I had osteoarthritis in both knees, carpel tunnel syndrome in right hand, ulnar nerve entrapment in both elbows. He wants to do a right knee total replacement, carpel tunnel surgery, ulnar nerve surgery in both elbows. I have put off the surgery, but live in constant pain and the pain has now spread to every joint on my body. I have extreme pain that last all day and I'm waken at night with it. I use to take 4-6 Aleeves a day, but was just recently diagnosed with an ulcer so have had to stop taking Aleeve. I very recently saw a Rheumatologist to help me with the pain. He did x-rays and bloodwork. I should know the results in one week. I have also been diagnosed with lung nodules, which have been repeated with CT scans 3 times and no growth. I have nodules under my skin by my ankles. I break out with a pin-like rash under the skin around my ankles and elbows. I have no joint swelling, other than in my right knee. The only time my toes and top of my feet will swell is if I'm on them too long and then my toes look like vienna sausages. I hurt and he has put me on Celebrex and Ultram ER. When I get in sunlight for any lenght of time I will break out in a raised red rash on my face and body. My Rheumatologist suspects RA.

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Answers (3)

Saturday, March 28, 2009

tessie

Well bless your heart, Peanut! You are definitely hosting quite an autoimmune party, huh? I'm so sorry.

I have RA, and you certainly have hallmark signs of RA. I'm sure that you know the skin rash sounds Lupus-like, but really your bloodwork will steer the differential diagnosis as Lupus and RA and other autoimmune disease share quite a few features.

Speaking from an RA perspective, not swelling isn't uncommon even when your joints are inflammed. Again, bloodwork will be able to reveal any ongoing inflammation. Pain can be present with RA without any visible signs.

It sounds like you have had issues for years. It is possible that you have developed OA as a result of RA, which again is quite common. I don't know your age or activity level, so its hard to know how you or your docs have been conceptualizing all these symptoms for so many years.

Again, so sorry you are dealing with all this.

Thank you for your input
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Monday, March 30, 2009

Shelly AKA "TAWANDA"

Hey Peanut, Definitely the autoimmune party going on with you! I was seeing an orthopedic doctor initially when I developed bilateral (both hands) carpal tunnel. Nerve conduction studies confirmed the diagnosis and he was encouraging me to have surgery. I elected to try treatment with steroids to decrease the inflammation instead. A 7 day dose pack was successful in quieting the inflammation for a few months at a time. I was reluctant to have surgery as I was suspicious that something systemic was going on with my body. I elected to see a rheumatologist like you have done which I think is an excellent decision on your part. By the time I saw a rheumatologist, I was having pain in my elbows and my shoulders. I was experiencing extreme fatigue, feeling like I had the flu and spending about 2-3 days a week out of 7 in bed sleeping. I have a strong family history of Lupus (mother, aunt, cousins) and had a positive ANA about 6 years ago after some minor joint pain in my hands that was present during the summer months for a couple of years but always went away in the fall. I did not have the characteristic butterfly rash common with lupus. My family doc at that time suspected Lupus but an occasional advil and limited time in the sun worked to control my symptoms, so I didn't think much about it until the carpal tunnel and other joint symptoms emerged with a vengeance 2 years ago. My rheumatologist surprisingly diagnosed me with RA instead of Lupus due to the severity of my joint pain and lack of other organ involvement. My lab work has been inconsistent in confirming or ruling out either diagnosis. I have had positive and negative ANA tests, RA factor etc. My doctor has explained to me that at this stage of the game that Lupus and RA are treated very similarly so we don't argue over labels. The bottom line is thank goodness I did not let the ortho doc do surgery on me. He was not wrong in his diagnosis, he just wasn't looking at the big picture and he was suggesting treatment that is his specialty .... orthopedic surgery. Now that my underlying autoimmune disorder is being treated, I rarely have problems with carpel tunnel and surgery was avoided! So, kudos to you for getting a second opinion! Good luck in getting an accurate diagnosis so you can continue your journey to recovery. Shelly

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Thursday, April 09, 2009

kalola813

have you asked your doctor about the possibility of sarcoidosis? it sounds like it with the rash and the areas affected. i am not a doctor but my cousin suffers from sarcoidosis and many of the symptoms sounded like hers. this is also a auto immune disease and can mirror many symptoms of ra. just a suggestion...