Inflammatory Arthritis - My Diagnosis?

[InnerBeauty]

From what I can see Inflammatory Arthritis is an umbrella term, and can cover several diseases, so I'm non the wiser really. My Rheumatologist came to this diagnosis after my ultrasound highlighted inflammation in both my hands and wrists. She also said I have some ana in my blood, but could not sure what is triggering the inflammation. I've been put on Sulfasalazine 500mg to be increasing to 2000mg per day over the next six weeks. I also have to have 2 more blood tests every until I go back to clinic in 6 weeks. I have pain in most of my joints everyday and also taken Naproxen 1000mg a day, and Amitriptyline 25mg once a day and 1000mg co-codamol as when required.

She said I'll be seeing a lot more of her now and that I will be seeing a Nurse in clinic regularly. Has anyone else been given this diagnosis?

[helixhelix]

It can often take quite a while to get to a specific diagnosis as many of this family of diseases overlap each other. So it's quite common for you to get an initial diagnosis of inflammatory arthritis, or indeed the even more general 'mixed connective tissue disorder', and then further down the line it will be revised to something more precise when it's clear how it is developing. But initial treatment for many of them is the same, and sometimes you can only get to precise diagnosis by seeing how people respond to treatment. So don't fret too much about the label you've been given. Hope the sulpha makes a difference to you and starts to get it under control - although it can take 3 months or so to do so.

[Pollymolly]

Hope you don't mind me asking, but did the rheumatologist do any other tests or ask any other questions before suggesting inflammatory arthritis? I'm curious as after being told I have fibromyalgia for a few years, my joints have been increasingly sore and an ultrasound ordered by my gp showed synovitis in my hands/fingers. I'm wondering if that pretty definitely means inflammatory arthritis of some kind? I've had a referral to rheumatology but there's not even any appointments available to book. I just want to know and to get treatment if there's something that might help. So it's interesting to hear you were just told inflammatory arthritis without specifics. Is that quite normal then?

[helixhelix in reply to Pollymolly]

It's good that your GP has referred you to a rheumatologist if you have active synovitis. Do you know if your inflammatory markers (the ESR or CRP blood tests) are raised as well?

These diseases are quite complex, and there isn't a single test that determines 100% which one you have, so it comes down to a specialist looking at your test results, your physical symptom, how you respond to treatments and how you say you feel to come to a view about what you have. It's quite possible to have fibro and RA sadly, as you start with one disease and then get another. A lot of us with auto-immune diseases and up with several - like buses! So your initial diagnosis could well have been the right one, but things do change.

But a broad diagnosis of inflammatory arthritis is quite common as far as I know.

[Pollymolly in reply to helixhelix]

My blood was negative in 2013 when I got the fibro diagnosis and my gp seemed reluctant to test again. Can it change? It's a three week wait to get the blood tests done. I'm using my credit card to pay to see a private rheumatologist as I don't want to wait anymore. My hands aren't as stiff and sore as they are, but now my knees are both very sore in the night and when i bend them (ie going down stairs hurts). Is the fact the hands are better but knees have started (this is new - though they've been achey in the past) suggest it's not RA? I'm just worried about being listened to about things. And I had cancer and chemo in 2012 so i worry that pain is the cancer coming back in my bones! It's hard to have anyone listen to me as they just think I'm a hypochondriac. But I kind of feel I'm getting somewhere now. Is it best to stay off painkillers before seeing a rheumatologist so the pain is there? I take dihydrocodeine - and duloxetine really helps too. Sorry for rambling and I'm really buttong in here! X

[helixhelix in reply to Pollymolly]

Hopefully Inner beauty won't mind you butting in on her post, but you can always write one yourself so you get replies from more people.

Anyway, there are different groups of blood tests. You may have been referring to having had the test for rheumatoid factor in 2013,and that being negative at that time. Well it can change, just because you were negative then doesn't mean you are still negative.

I was referring to the tests for inflammatory markers, which your GP can do, which change all the time but give a pretty good indication of whether there is inflammation in your body. If you have had cancer previously I'd have thought your GP should be sympathetic to your worry and do extra tests for you?

[Pollymolly in reply to helixhelix]

You'd think so wouldn't you! But I think they've written 'hypochondriac' on my file because I keep going back about being in pain.

I thought the rheumatoid factor could change so I didn't understand why she didn't want to test it again - especially given the swelling. And if inflammatory markers always change, why not test?

My NHS appointment came through - end of September. So I think/hope it's going to be worth paying to see someone next week.

I want fixing and if it is RA I want to prevent any major damage. I'm getting increasingly 'waddly' in the way I walk and struggle to stand up sometimes - I'm 38 and people look at me strangely.

I keep starting my own post but I start rambling and have so many questions i don't know how to start! Thank you for your help. X

[InnerBeauty in reply to Pollymolly]

The other tests my rheumatologist did are as follows with the results:-

1. I am Neutropenic since June 2014 - (1.5) (Now better at 2.2 June 2015)

2. ANA - 1600

3. Anti-Ro52 - Positive

4. RNP Antibody - Positive

5. ENA - Positive

6. ANA - Positive

7. ds DNA Antibodies - Normal

8. ESR - 31

I was surprised that she didn't think I had any active diseases even with these blood results. She changed her mind after I had a ultrasound on my hands and wrists. So I'm actually getting some treatment now. She said she was starting me off with the gentlest medication to see how I get on.

Hope this information helps you. x

[Pollymolly in reply to InnerBeauty]

Thanks innerbeauty. I'm so sorry for butting in! What are ANA and ENA? Interesting about the neutropenia - is that normal with RA? My wbc has been low since chemo and should have gone back to normal range. Are your joints very visibly swollen?

[InnerBeauty in reply to Pollymolly]

The joints in my hand are visibly swollen, although the Rheumy did not think they looked bad, they felt bad to me. Very painful to pick things up or hold a pen. To be honest my whole body aches and I feel very stiff most of the time, can't wait for these new tablets to kick in.

[Pollymolly in reply to InnerBeauty]

I hope they kick in soon x

[beckywebb04]

I was given almost exactly the same diagnosis as you. Raised inflammation and wrist ultrasound showed synovitis. My rheumatoid factor blood test was negative so in the end along with my symptoms of fatigue, morning stiffness, symmetrical pain etc. I was given the diagnosis of seronegative rheumatoid arthritis

[Hidden]

Yes....your treatment is almost exactly the same as mine.