PMR or Ra

[Judyp1203]

I need opinion again. Diagnosed in March With PMR. 20mg of Prednisone. Down to 9mg a month ago pain was severe in right shoulder. Doctor sent me for MRI. MRI showed Synivitis and Effusion. Now doctor thinks possibly RA. She did 1 cortisone shot in my shoulder. And brought up the dreaded medicine Methotrexite. I got a second opinion from Orthopedic doctor. He said I might need arthscopic surgery to have fluid removed. Should I ask doctor for blood test RF, ANTI-CCP and ANA before I go on MXT? Appreciate any advice!

JudyP

[PMRpro Ambassador]

Methotrexate is the first line drug for RA so it is logical to try it if she suspects your PMR may really be RA. Mind you - synovitis and effusion can happen without it being RA and I would have thought they would have looked for evidence in more joints. If it were me, I'd want a proper second opinion I think - and more evidence.

rawarrior.com/the-1st-dose-...

[Estellemac]

I would want a Rheumatologist opinion or did that Consultant diagnose the PMR and order the MRI? They know best if you can get an appointment.

[Judyp1203 in reply to Estellemac]

The doctor is a rheumatologist. Should I ask for those blood tests RF, ANTI-CCCP and ANA?

[Estellemac in reply to Judyp1203]

I would you’ve nothing to loose.

[Oldman-1]

Personally, a consultant has more experience in diagnosis in that persons medical field. This is the catch 22, There are so many pros and cons here, but you have to start some where. so which ever sounds most sensible for you.

[Augustus-6 in reply to Oldman-1]

Yes i agree i started with pmr which moved into ra 15 years ago. Ive only ever taken pred mostly 5 mg. if i have a flare i take 20mg 2 or 3 days later back to 5mg so i manage it myself. Im scared of all these disease modifying drugs. Ive recently been told the pred causes heart disease as does ra. 6 years ago i had 5 stents. Its all a nightmare.

[Amkoffee]

I was diagnosed with PMR in September 2016. And Friday following an MRI of my right hand the previous day my rheumatologist told me I had RA. I want to point out that it is very possible and very likely that you have both diseases. It doesn't have to be one or the other and as I've been told by others who have PMR and RA that having an inflammatory arthritis is a very common thing with PMR. PMR can manifested into RA or you can have both at the same time. One affects the muscles and the other affects the joints.

[WanderingMike in reply to Amkoffee]

I too originally had RA or rather the actual diagnosis was just inflammatory arthritis. I was taking an antibiotic treatment (minocycline) for that. Then it seemingly morphed into PMR for which I am taking a low dose of Prednisone and am keeping it in check. Now, with vegan diet, I have gone off the antibiotics and the RA seems to be silent but if I drop below 5 mg Prednisone, the PMR symptoms start acting up. So, my thought is there is nothing to keep you from having both.

[Judyp1203]

Thanks for the advice....I don’t want to face that I might have RA.

[daworm]

I am also wondering about this...one thing for sure, I would have a second opinion...which I myself may be seeking soon...

[Amkoffee]

Judy I have 3 painful conditions and I have to admit that I am pretty mad at God right now for giving me all these conditions and making me suffer. So I do feel your pain so to speak. Nobody should have to endure this kind of pain.

[Judyp1203]

Again thanks for the responses. I am just totally confused. I got an appointment tomorrow with my rheumatologist. I just want to know for sure if I have RA. I really do not want to take Methotrexite unless it’s for sure RA. I would rather just deal with the pain if it is PMR only. I was wondering will Methotrexite make the synovitis in my shoulder disappear?

[PMRpro Ambassador in reply to Judyp1203]

I wouldn't have though so - I'd have though an increase in pred was called for in the short term. Long term is maybe another question.

[Amkoffee in reply to Judyp1203]

There is a handful of other medication to take for ra. I cannot take Methotrexate because of my liver. But my rheumatologist listed four or five different medications and she's going to put me on one of those.

[Augustus-6]

I had pmr for 3 years which developed into ra which ive had 15 years i struggle along on 5 mg pred as i dont fancy all these disease modifying drugs.