Update on preliminary diagnosis of RA

[greenwalls]

Update from first post regarding preliminary diagnosis of RA.

After my last post I was seen 2 weeks ago at the early arthritis Clinc at hospital. Consultant did exam, took history, looked at the blood results, X-ray hands & feet & ultrasound hands, wrists, feet & ankles.

X-ray showed no erosions, ultrasound no synovitis but a Tendonitis in one wrist, bloods elevated RF & slightly raised CRP (12),

Her conclusion - not rheumatoid but;

Hormonal related joint arthralgia due to sudden oestrogen drop of menopause & possible viral infection trigger, age appropriate OA & local irritation (tendonopathy) because of above.

Her advice

Seek out hormone advice on menopause related issue (start HRT) but could be looking at 18-24 months before this settles down due to the hormonal changes

In the meantime advice was to have a v quiet 3 months - 100% good nutrition, gentle exercise, minimal stress, pain relief as needed & review in 3 months. That’s the plan to see if it can settle down.

I am still struggling with same symptoms - pain/stiffness malt joints, flu like symptoms as day goes on if I do too much - but no unbearable pain at night - presumably because I have really cut down on what I’m doing.

Current lockdown will help me achieve this 3 month plan so I guess everything has a silver lining.

Do any of you have any thoughts on this diagnosis?

[allanah]

Think I'd do what the consultant says , and review how you are getting on in 6 months? Sounds thorough to me?

[helixhelix]

I read an interesting research paper sometime ago which I now can’t find (and I kick myself for not saving it). Basically it said that there was developing evidence that women in particular who had very early stage inflammatory arthritis could push it back into remission by lifestyle changes. So go for it. It can’t harm you and may well help.

[Deniseelk]

Greenwalls, that certainly sounds a far more encouraging diagnosis than RA! Specialist seems to be thorough and with a plan for you. Do take a look at menopause_doctor ( I follow her Instagram) as she has some very helpful advice based upon current research and she dispells the incorrect reporting on HRT safety too! I have recently started HRT ( Oestrogen patches plus Progesterone tablets) and so far so good and happy to keep you in the loop of how I am getting on. I would immerse yourself in the specialist’s advice which all seems very practical and easy to adapt your lifestyle too! You must be feeling very relieved.

[AgedCrone]

I think I’d give it a try, then after the 3 months when you get your bloods checked see if hospital Consultant can re confirms her original advice.

After all why start on RA drugs if there is a real chance not to?

I would wonder if you did start Dmards now you could just be popped into the RA Box, & if your Consultant really is right you’d probably have a hell of a job to get your diagnosis reinvestigated.

If you get what I mean?

HRT can have miraculous effects.....so unless you are very opposed to that route & you trust your Consultant .....why not give it a go?

Good Luck!

[greenwalls in reply to AgedCrone]

Thank you for the reply AgedCrone - do you mean I should try to keep an RA diagnosis as would be hard to reinstate it or do you mean the other way around?

[AgedCrone in reply to greenwalls]

Well what I think I meant (?) was to stay with your Consultant rheumatologist for RA reviews after taking the HRT route....if that is an option of course.

Then after whatever HRT Doctor & Rheumy think x months down the line ...if they think the HRT route is working..no increased CRP & Rh factor & you are feeling more comfortable & most important Rheumy still thinks it’s the way to go....you have to think about it.

I took HRT from 48...didn’t have any RA symptoms....sailed through the menopause.....but was then diagnosed with Palindromic Arthritis at 57 which morphed into full blown RA at 59.

Would I have developed the RA sooner without the HRT? Who knows?

I was diagnosed early enough not to have any joint damage and I did get an extra nine years with no RA Drugs.

But obviously that’s not scientific .....just the way it went for me.

You’ve got a puzzle on your hands green walls.