Re: Cloudy diagnosis--non-symetrical pain

[Guest guest]

Hi

I have been lurking and reading for a while but my situation is similar to

Pam's so I decided to write.

I am 32, Irish but am married and living in southern, semi-tropical, Japan.

At the moment we are waiting for a typhoon to pass through... barrel of

laughs.

I was diagnosed with probable RA last December after going to a doctor

(surgery), who was also a rheumatologist, with what I thought/assumed was

tendinitis - pains from my wrist to knuckles.

My outer wrists were (I think) slightly swollen and revolving my hand or

carrying things was painful. I have had what I described as " dry " finger

joints at times but never really thought much of it.... Ignorance is bliss

(?).

Anyway, my symptoms are not what I would describe as symmetrical. I have had

pains in both hands and wrists, but not necessarily at the same time. I have

had swollen finger joints but again not at the same time. I don't have any

of the morning stiffness that all the books or internet lists have for

requirements for a RA diagnosis.

Currently I am on (and have been from the start) Mobic, AzulfidineEN, and

Prednisone (being tapered off). My blood tests have been clear from the

start.

In March I went home for a holiday and got an appt with a rheumy there. He

said that I don't have the necessary requirements for RA but said that I

fitted the profile of something called Palindromic Rheumatism. PR seems to

be a sudden, recurrent, brief episodic version, but I found very little on

the net.

My doctor here doesn't agree. He said the time span is too long. Anyway, he

reckons that I have a mild type of RA and says that if my blood tests are

still clear next time that we will further cut the medicine but keep on the

Azulfidine.

Do you require the stiffness to be RA? I've only ever had 1, max. 2 joints

painful at a time - is that enough for a diagnosis?

Does anyone know anything about Palindromic Rheumatism?

thanks for your time

AnneMarie

Pam said:

> Hi--I just joined this group. I do not have a definitive RA

diagnosis--right now my rheumatologist is calling it undifferentiated

> connective tissue disease (polyarthritis.) He has me come in every 3

months, and I am on Plaquenil and Mobic. In the past I was diagnosed with

lupus like syndrome, but my rheum. thinks it is more like RA.

Also, the pain is not symmetrical--for instance, right now my left ankle is

swollen and painful, but not the right. I thought that RA pain was always

symmetrical. And the bloodwork is not definitive for RA, but my

sedimentation rate is high. > Pam

>

[Guest guest]

Pam,

I do not have symmetrical pain with my RA and didn't from the start.

I have it in every joint except my hips, spine and jaw. My right

foot, ankle and knee are worse than the left. My left shoulder is

worse than my right and my right hand and wirst are slightly sorse

than the left.

My RA factor was 113 on first bllod test. Five days later it was 118

and 2 1/2 weeks later it was 164. Normal is between 0 and 20.

Good luck and God Bless,

Jay

--- In Rheumatoid Arthritis , " pamp81 " <Pamp81@a...>

wrote:

> Hi--I just joined this group. I do not have a definitive RA

diagnosis-

> -right now my rheumatologist is calling it undifferentiated

> connective tissue disease (polyarthritis.) He has me come in every

3

> months, and I am on Plaquenil and Mobic. In the past I was

diagnosed

> with lupus like syndrome, but my rheum. thinks it is more like RA.

> It seems to be worsening with time. I get swollen, painful joints,

> and when I flare I get little fevers and feel very fatigued and

ill.

> In general, I am fatigued from very little effort all the time.

Also,

> the pain is not symmetrical--for instance, right now my left ankle

is

> swollen and painful, but not the right. I thought that RA pain was

> always symmetrical. And the bloodwork is not definitive for RA, but

> my sedimentation rate is high. I was just wondering how many of you

> have symmetrical pain with your RA. I was under the impression

that

> RA was usually fairly easy to diagnose, but I am in limbo here.

> Thanks so much for any insight!

> Pam

[Guest guest]

Welcome to the group and condolonces for having a disease that brings you here. If things are continuing to get worse you probably need an increase in your medicines or a change in medicines or both. I was started out on Arava, added Methotrexate, dropped Arava, added Remicade, all with no success until the Remicade dose was increased from 3 mg/kg to 6 mg/kg. Now I consider myself to be pretty well controlled. It took changes of medicines and increases in dosages to get control. Some people get control with lower doses or less expensive medications but you need to use whatever it takes.

Some people have classical symptoms of RA and are fairly easy to diagnose but many others are not sufficiently definitive for quick or easy diagnosis. "According to the American College of Rheumatology, 4 of the following 7 symptoms indicate a diagnosis of rheumatoid arthritis:"1. Morning stiffness, lasting for at least an hour, present daily for at least 6 weeks"2. Arthritis of 3 or more joints, lasting for at least 6 weeks"3. Arthritis of the hand joints, lasting for at least 6 weeks"4. Symmetric arthritis, lasting for at least 6 weeks"5. Rheumatoid nodules"6. Positive rheumatoid factor (blood test)"7. Joint changes on x-ray"

From http://www.arthritisinsight.com/medical/disease/ra/ra.html .

You can pick any three of the symptoms and have those fairly strongly but still not be diagnosed with RA. Add a fourth symptom and the diagonsis becomes easy. I have all but the first symptom and at my first appointment I was diagnosed with probable RA based on the last three symptoms. For many people fatigue goes along with RA but it is not a recognized symptom for some reason unknown to me.

There are over 100 recognized kinds of arthritis with Osteoathritis (OA) being the most common and quite different from all the others. RA is next most common and often hard to tell from the remainder. Also RA is an autoimmune disease and people with one autoimmune disease are fairly likely to have other autoimmune diseases. Except for OA most arthritis can be treated as if it is RA with reasonable success although other treatments may be better if an accurate diagnosis can be made.

----- Original Message -----

From: pamp81

Rheumatoid Arthritis

Sent: Monday, June 16, 2003 1:24 PM

Subject: Cloudy diagnosis--non-symetrical pain

Hi--I just joined this group. I do not have a definitive RA diagnosis--right now my rheumatologist is calling it undifferentiated connective tissue disease (polyarthritis.) He has me come in every 3 months, and I am on Plaquenil and Mobic. In the past I was diagnosed with lupus like syndrome, but my rheum. thinks it is more like RA. It seems to be worsening with time. I get swollen, painful joints, and when I flare I get little fevers and feel very fatigued and ill. In general, I am fatigued from very little effort all the time. Also, the pain is not symmetrical--for instance, right now my left ankle is swollen and painful, but not the right. I thought that RA pain was always symmetrical. And the bloodwork is not definitive for RA, but my sedimentation rate is high. I was just wondering how many of you have symmetrical pain with your RA. I was under the impression that RA was usually fairly easy to diagnose, but I am in limbo here. Thanks so much for any insight!Pam

[Guest guest]

Thank you for all of the nice replies. I know this group will be

helpful. Thanks so much.

Pam

> Welcome to the group and condolonces for having a disease that

brings you here. If things are continuing to get worse you probably

need an increase in your medicines or a change in medicines or both.

I was started out on Arava, added Methotrexate, dropped Arava, added

Remicade, all with no success until the Remicade dose was increased

from 3 mg/kg to 6 mg/kg. Now I consider myself to be pretty well

controlled. It took changes of medicines and increases in dosages to

get control. Some people get control with lower doses or less

expensive medications but you need to use whatever it takes.

>

> Some people have classical symptoms of RA and are fairly easy to

diagnose but many others are not sufficiently definitive for quick or

easy diagnosis. " According to the American College of Rheumatology,

4 of the following 7 symptoms indicate a diagnosis of rheumatoid

arthritis:

>

> " 1. Morning stiffness, lasting for at least an hour, present daily

for at least 6 weeks

> " 2. Arthritis of 3 or more joints, lasting for at least 6 weeks

> " 3. Arthritis of the hand joints, lasting for at least 6 weeks

> " 4. Symmetric arthritis, lasting for at least 6 weeks

> " 5. Rheumatoid nodules

> " 6. Positive rheumatoid factor (blood test)

> " 7. Joint changes on x-ray "

> From http://www.arthritisinsight.com/medical/disease/ra/ra.html .

> You can pick any three of the symptoms and have those fairly

strongly but still not be diagnosed with RA. Add a fourth symptom

and the diagonsis becomes easy. I have all but the first symptom and

at my first appointment I was diagnosed with probable RA based on the

last three symptoms. For many people fatigue goes along with RA but

it is not a recognized symptom for some reason unknown to me.

>

> There are over 100 recognized kinds of arthritis with Osteoathritis

(OA) being the most common and quite different from all the others.

RA is next most common and often hard to tell from the remainder.

Also RA is an autoimmune disease and people with one autoimmune

disease are fairly likely to have other autoimmune diseases. Except

for OA most arthritis can be treated as if it is RA with reasonable

success although other treatments may be better if an accurate

diagnosis can be made.

>

>

> ----- Original Message -----

> From: pamp81

> Rheumatoid Arthritis

> Sent: Monday, June 16, 2003 1:24 PM

> Subject: Cloudy diagnosis--non-symetrical

pain

>

>

> Hi--I just joined this group. I do not have a definitive RA

diagnosis-

> -right now my rheumatologist is calling it undifferentiated

> connective tissue disease (polyarthritis.) He has me come in

every 3

> months, and I am on Plaquenil and Mobic. In the past I was

diagnosed

> with lupus like syndrome, but my rheum. thinks it is more like

RA.

> It seems to be worsening with time. I get swollen, painful

joints,

> and when I flare I get little fevers and feel very fatigued and

ill.

> In general, I am fatigued from very little effort all the time.

Also,

> the pain is not symmetrical--for instance, right now my left

ankle is

> swollen and painful, but not the right. I thought that RA pain

was

> always symmetrical. And the bloodwork is not definitive for RA,

but

> my sedimentation rate is high. I was just wondering how many of

you

> have symmetrical pain with your RA. I was under the impression

that

> RA was usually fairly easy to diagnose, but I am in limbo here.

> Thanks so much for any insight!

> Pam

>

>

>

>

[Guest guest]

Hi Pam,

Just to let you know RA is not always symetrical in pain or

swelling. I was disgnosed with JRA at 15 and still fight with the

disease at 33. My pain and swelling are not always symetrical. It

depends on the level of damage done to the joint and the amount of

swelling in that joint. Also, the RA tests do not always show a

positive RH factor. As a child my test was positive, however as an

adult I am always within normal ranges. Its more important to look

at your symptoms and listening to your body.

There are many drugs and lifesytle changes that can dramtically

improve your quality of life. I have controlled my Ra for the last

couple of years myself (I don't have health insurance). So, I know

its possible to live a fairly normal life.

Good Luck!

--- In Rheumatoid Arthritis , " pamp81 " <Pamp81@a...>

wrote:

> Hi--I just joined this group. I do not have a definitive RA

diagnosis-

> -right now my rheumatologist is calling it undifferentiated

> connective tissue disease (polyarthritis.) He has me come in every

3

> months, and I am on Plaquenil and Mobic. In the past I was

diagnosed

> with lupus like syndrome, but my rheum. thinks it is more like RA.

> It seems to be worsening with time. I get swollen, painful joints,

> and when I flare I get little fevers and feel very fatigued and

ill.

> In general, I am fatigued from very little effort all the time.

Also,

> the pain is not symmetrical--for instance, right now my left ankle

is

> swollen and painful, but not the right. I thought that RA pain was

> always symmetrical. And the bloodwork is not definitive for RA, but

> my sedimentation rate is high. I was just wondering how many of you

> have symmetrical pain with your RA. I was under the impression

that

> RA was usually fairly easy to diagnose, but I am in limbo here.

> Thanks so much for any insight!

> Pam