~Rampant tendinitis & scaley looking skin anyone?~

[Megams]

Hi team of helpful supporters: - in looking over some of my old threads I note my complaint of tendon and ligament issues.

Swollen ankles, mainly the R which has been problematic since I rolled it January 2016 and again Oct 2016. Recent x-ray has ruled out arthritis but confirmed split/ tear of peroneus brevis tendon with surrounding tenosynovitis.

Tennis elbow L & R plus flare of symptoms in the R distal gluteus minimus & medius tendons + trochanteric bursitis.

My symptoms of most of the above flared considerably since returning to my favorite exercise - a gentle beach walk. I realize it is highly likely due to the unevenness of the sand.

Physio suggested he refer me to an ankle surgeon but I would prefer not to have surgery if at all at this stage - I see a Sports Physician in a week's time.

I have been having weekly physio/acupuncture & ultra sound on R ankle. All these affected areas have had steroid injections in the past so Rheumy has started prolotherapy which takes time as my system seems able to cope with one injection at a time - leaves me feeling drained & unwell for days afterwards.

Appreciating that there would be a significant deal of inflammation within the areas affected, would there be a possibility that this inflammation would increase my PMR symptoms or overall inflammation level? I am not stiff in the muscles first thing in the morning but I am certainly struggling with getting comfortable at night when trying to sleep.

Also wondering if folk have noticed their skin flaking off in various areas, legs, arms, (patches) which appear to have removed the protective layer & leaving white scale like circles - is it virtiligo or similar?? I am not sure if this is PMR related or my under active thyroid which I've had a good 9 years or so?

I certainly know that this summer I will need to cover up completely as it appears I have lost my melanin in many places & soon it will be like joining up all the dots!

Thanks team as always - never a dull moment is there?

Abundant blessings one and all.

[SheffieldJane]

Hi Megams,

It seems sad that a gentle beach walk causes you such problems. I've been wracking my brains about bare feet or different footwear. It will benefit you in every other way. I suppose it's flatter just at the sea's edge. Don't give up!

I am not familiar with prolotherapy, I hope it's worth it as it makes you suffer actually too much.

I have Graves Disease but I nearly think about it as being a factor. I was diagnosed in the 80's and take thyroxine for life.

My feet look like they've been scalded when I use prescribed creams and a bit as you describe untreated. Diagnosis Psoriasis. It has kicked off now I am on a lower Pred dose, it had almost gone.

Your bloods will show additional inflammation and PMR/ GCA loves a friend so yes probably worse.

[Megams in reply to SheffieldJane]

Hi SheffieldJane - thank you for your response.

The Prolotherapy is used by my Rheumy and if there is no long term response from a small amount of injected steroid to inflamed regions i.e tendons/ligaments + other areas then Rheumy will suggest trying the Prolotherapy.

He uses minute doses (1ml) of Polydocanol (sclerosing agent) & Citanest as anesthetic.

I have always been most sensitive to most chemicals/food ingredients ingested or otherwise. As I've got older I've become a lot more sensitive for whatever reason. My throat swelled up in response to a feta cheese omelette & at the same time I broke out into a bright pink itchy rash across my lower abdomen - I once could eat a small amount of feta.

I am staying away from the beach for the moment & working out at my usual YMCA rhythm & movement classes until ankle dealt to.

I note that those with hyperthyroid (Graves disease) may possibily be more prone to vitiligo after doing some more research & doesn't quite fit my skin changes completely, but the theory seems similar with the body attacking the melanocytes in skin leaving pearly white circles/patches.

My sister-in-law had thyroid cancer, is slightly olive skinned but slowly losing all her pigment - she is turning completely white bit by bit.

My 3 monthly bloods for 2017 (completed early September) has seen a continual but very slight rise in my ESR from 3 to 12 - it is still well within range. I will keep close eye as it was 1 when diagnosed Jan 2015 with PMR.

Blessings once more.

[SheffieldJane in reply to Megams]

Thank you for the information Megams. I hope the treatment proves to suit you better.

We can only hope that this too will pass.

[PMRpro Ambassador]

I assume you have googled vitiligo - does it fit? It can be an autoimmune condition too. I wonder if all this is as simple as it looks?

I can't walk on sand - unless it is the really hard wet stuff at the edge of the sea. Unfortunately one usually has to walk across the other stuff to get to it!

[Megams in reply to PMRpro]

Hi PMRpro - no I hadn't googled in any depth per se but am keen to learn more. Seeing Rheumy Thursday so hope he can shed some light.

I understand there may be a possibility of a genetic factor associated with vitiligo - if this is the right name I've given it. My late Mother had these scales/white patches on her legs & arms which she thought was natural part of ageing. She went on to develop Parkinson's disease.

Completely understand your comment re walking "across the other stuff" to get to the stuff at the edge of the sea. Can't wait to return as its my absolutely fav pastime in summer - when it finally arrives one day!!

While I think of it - I did seek a 2nd opinion earlier this year with another Rheumy. He did write psoriatic arthritis on my blood form? + sent me for nail parings as two nails appeared to be slightly lifting from nail bed which was a clue at time? It is a difficult condition to diagnose altho I do recall reading that tendinitis is problem associated with this autoimmune complaint. Result from lab - inconclusive.

Blessings once more.