ongoing knee issue

[letmein147]

hi, been on steroids, methotrexate, yuflyma for almost a year. When I reduce down on the steroids my knee is so painful I have to go back on steroids within days. This is ongoing for a year now, X-ray from last year to now doesn’t show much change, so what is causing this severe pain, I have no swelling or puffiness-any ideas

[helixhelix]

you might be better to ask for an ultrasound. That might show whether you have a knee effusion, which can be internal so not show much external swelling.

[Runrig01]

Iis possible it’s part of steroid withdrawal which can cause jobs & muscle pain. I’m not keen on using steroids for pain, when other options are available. I was on steroids for years and developed several insufficiency from it, which caused a severe stroke, which is how I was diagnosed with AI. The stroke was Diego s crisis from lack of cortisol. I’m now on steroids for life, wake up lifeless till my steroids kick in, 2hrs later, and carry an emergency intramuscular injection which has Ben used on several occasion. It’s a horrible illness, quickly making you sick, lightheaded, fatigued and will progress to serious organ failure or death if not treated.

I agree with HH, that an ultrasound would be better, it shows up soft Sadie injury or inflammation, as well as effusions, although they do tend to show up on Xrays.

[wilbertjellyfish]

A day I'm also on the yo-yo steroid thing. Firstly you need to cut them slowly. Currently I am reducing my 1 mg per month. Speak to your rheumy team. You do feel worse for a day or two the week after you cut them. This is because your own adrenal glands need time to adjust and make more of their own. et

A steroid injection in your knee might be an option to get it to settle down and allow you to cut the tablets.

It's good the x-rays are clear but RA attacks the soft tissue of the body so it doesn't always show on x-ray

[Rusticgarden]

Maybe osteoarthritis, when I have my infusion it has steroids with it ,I walk out feeling great but within a few days my knee sore as steroids wear off

[PianoPlayer11 in reply to Rusticgarden]

As has been said- could it be osteoarthritis? I have that in both knees which means constant pain regardless of what’s going on with my RA.

[bienassis]

I agree with other responses that X Rays on rheumatoid joints are not very helpful - an Ultra Sound scan will reveal any damage more successfully. X Rays are cheaper and quicker, but not what you want for rheumatoid disease. In the past, when my rheumy as suggested X Rays, I’ve always replied that I would prefer an Ultra Sound Scan - and interestingly the rheumy nurse has always agreed with me!

Steroids are fine as a quick fix while something else is considered, but they have to be looked upon as temporary as long-term they are very damaging.

Discuss with your Rheumy. Don’t leave it too long.

[PCStrawberry]

My wife is in the same boat. When Humira first started to sputter, eventually not working at all, she needed steroids for support. And when she switched to Enbrel, it never worked fully, she was dependent on them. In her case, they're not needed when her biological is working as intended. She can't take MTX due to kidney disease, therefore it's a non-factor. Personally, I'd advise a discussion with your MD, maybe a JAK inhibitor could be a better solution.

[tyncwmmarchhywel]

hi letmein, do you mind me asking what dosage of steroid.