Is it rheumatoid pain?

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Diagnosed in last 6 months.  Currently taking methatrexate injections.  I see 2 rheumatologists, one local and one in a large city who I trust more but difficult to get there.  I am uncertain what I am dealing with. My local Dr tells me i should have no pain as my sed rate etc is normal.  I have severe bilateral hip pain.  Some nights it feels like my legs weigh 200 lbs and cant even be moved to roll over in bed.  Many days it is very painful to walk.  On some days I feel minimala  hip pain, but I feel like my old self again.  My mri showed osteo necrosis but my ortho is not sure that is correct.  He wants me to try another steroid injection which did help minimally a month ago. My big city rheumatologist says of course it is all rheumatoid pain.  Does anyone else have these symptoms?  I really do not know where to go from here.  On some days I feel I should proceed with joint replacement...but on good days I'm still very uncertain.  I'm so unsure of what rheumatoid pain even feels like!  I'm now 64 and was very active till this struck.  Not anymore.

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  • Posted

    I also have bilateral hip pain that came on before my RA diagnosis. In my case, I had FAI with Labral tears and ended up having arthroscopic surgery on both hips to fix it. Hopefully you figure out what's going on soon!
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  • Posted

    If an mri  shows osteo necrosis, don't you need surgery before more joint damage occurs? Or is the Mri not that clear?

    Maybe it s the fluctuating pain that is puzzling- but you don't mention pain in other areas. Presumably you also have ' typical' pain and stiffness in fingers/ wrists/ feet/ knees/shoulders ( or some of those ) to have an RA diagnosis. Is the methotrexate helping that? Is the hip pain better when other pains improve too? Has your rheumy who says it s all RA suggested any further meds?

    just trying to ask the questions I would ask myself in your situation. I would ask the ortho why he is unsure about that diagnosis.

    Yes a corticosteroid would help pain , whether RA or osteo caused, but will only deal with symptoms. It seems to me you need to know whether to have surgery or have more effective RA meds before having the cortisone to ease symptoms as you will be no wiser as to the root cause of this continued pain.

    my friend in her mid fifties has had both hips replaced and it has made a huge difference to pain .

    wishing you the best as you try to get clarity from the health professionals.

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    • Posted

      Saw my primary this week...the mri was totally unclear..looks like necrosis...could be bruising from osteo..but presents exactly as necrosis.  See why im confused!  Anyway she sent me to orthopedic surgeon who I am seeing Thursday.  I do NOT feel I have typical rheumy large lump onhand knucle which was very little pain even before dx..just ugly.  Rheumatologist that feels this is all rheumatoid related increased methotrexate by .1 ml.  I began that increase 8 days ago and am on my 6th day of no severe hip pain.  That is the longest i have ever gone since Im wondering...could this be it??  I increase again in two more weeks.  Now im wondering if this is really working for me, will I become immune to this dose and have to keep increasing??  Beginning to understand the frustration with this disease!
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    • Posted

      Yes, very confusing!

      but if the methotrexate is having an effect?.........

      i have 25 gm of tablet methotrexate a week. As I understand it, it s just a case of finding the dose that works( up to a level) if that still doesn't work they add another dmard .

      RA is certainly a strange thing- and no two people the same. I guess you ll just have to pursue 2 lines of enquiry( osteo and RA ) until something makes sense! 

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  • Posted

    " My local Dr tells me i should have no pain as my sed rate etc is normal."

    What a load of rubbish! Was your sed rate ever raised? I have polymyalgia rheumatica and have never had a raised sed rate, not even out of single figures, even when I couldn't move. I have friends with RA who know they have a flare days, even weeks, before the sed rate goes up - often it lags behind.

    However - your description of "concrete legs" is something I hear all the time from patients with polymyalgia rheumatica. It only responds to pred - the MTX won't do anything for that. Have you had any oral pred or just the single injection?

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