Bad Right Hip
Posted , 6 users are following.
I just marked 4 years with PMR. The diagnosis began with pain in my right hip which was X-rayed and said to be mild OA. At the moment, on 6 mg Medrol-heading to 5.5mg, without any PMR issues. I also have Osteoporis and after 3 years on Reclast, just began Tymlos. I've been having pain in my right hip which was x-rayed yesterday and found to have severe OA and avascular necrosis. Rheum wants me off Medrol ASAP and to begin Methotrexate which I have been resisting. I will be seeing Orthopedist. Any advice, all you wise folks?
0 likes, 9 replies
Vicki200252 SectionedThrice
Posted
no advice sorry, just wishing you all the best.
Anhaga SectionedThrice
Posted
Mtx isn't a substitute for pred if you have PMR. It works for RA but not for PMR. I remember when I first started reading posts on this forum there was a woman who had to have hip replacements because of avascular necrosis. I don't remember if she had to eliminate her pred completely but I know she had to reduce it. There is another issue which mtx certainly won't help with - whether your own adrenal glands are producing sufficient cortisol. At least you are already below the level the body normally produces, so your adrenal glands are working, but to get up to the right level can be very slow. I believe avascular necrosis is a rare side effect which occurs in some people because blood circulation is relatively poor to the area.
https://patient.info/forums/discuss/avascular-necrosis-478045
I had a private chat with Gail and will try to find that again in case there was anything helpful in what she said there.
Anhaga
Posted
I don't think I can find the right conversation. Too bad there isn't a clearer date than "3 years ago"!
Anhaga
Posted
I found it! I don't know if you will be able to read it, and maybe not useful anyway, but I'll private message you.
ptolemy Anhaga
Posted
If you are on Methotrexate you are normally told to stop taking it before the operation. I was also told to stop glucosamine.
Anhaga ptolemy
Posted
Ptolemy, Your reply meant for SectionedThrice?
ptolemy Anhaga
Posted
whoops sorry.
EileenH SectionedThrice
Posted
He can't stop your Medrol just like that at that dose without seeing if your adrenal function returns to normal - that would be very dangerous and he needs to speak to an endocrinologist about the best way to go about it.
Methotrexate is very unlikely to replace pred if the PMR is still active - but you won't know that without stopping the pred. Catch-22!
SectionedThrice EileenH
Posted
EileenH--he wasn't suggesting stopping just like that, but maybe 0.5 mg reduction of Medrol each week and see how that goes--rather than the "British" plan I learned here with a much longer transition.