MRI results clear, now what?

[Griggser]

As the title suggests I've just had the results of my recent MRI scan and there are no significant abnornamilities. So why am I in such pain in both hips? I'm on 12mg of pred, had to go back up from 10 to 15 a while ago and tapered back to 12. However even at 15mg my hips were not really any better and each time I've gone below 12mg it becomes miserable. The pain and stiffness seem to be getting worse, wake in the night and in agony and after driving for an hour and very stiff and it's painful to even get out of the car. It does ease back to what I call "normal" after walking just a short while to get things moving. I'm not due to see the rheumy for a couple of months and am not sure what to do next, do I just stay at 12mg or try to taper on the dead slow method? Anybody out there with a magic wand can you wave it my way please.

[Hidden]

Hi Griggser

No magic wand l’m afraid, sorry.

Has your GP offered you any painkillers to make you more comfortable? It does sound as if the PMR is playing up with the stiffening up when you drive & getting out of the car.

You could try going back to 13mg & see if it feels any better.

Hoping you feel some improvement soon.

Kind Regards

MrsN

[Griggser in reply to Hidden]

Thanks Mrs Nails, I’m taking Zapain for pain relief. Two when I go to bed and two st about 3am as I’m then so uncomfortable and in pain. I try not to take anymore during the day but usually fail and take at least two. To be honest I didn’t feel any different at 13, 14 or 15mg. It seems 12 is my magic number although I would like to be in less pain. I’ve sort off accepted, for now, that I can function at this level so I’ll stick with it.

[Hidden in reply to Griggser]

Sometimes it’s better in pain management to keep a more even dose throughout the day, so the pain doesn’t get beyond what you can cope with.

I have my codeine separately in 15mg/30mg Tablets so l can choose which l need. This regime was set up for me long before PMR by a Pain Management Specialist, it was actually the same chap that diagnosed my PMR

No one wants to be on Pain Meds all the time but sometimes we have to accept there are other things running alongside our PMR & if anyone is proving that rule it’s me! 😉

I hope you can find some relief as constant pain especially at night is extremely wearing.

Kind Regards

MrsN

[PMRpro Ambassador]

You sent me to look! And I was right:

"MRI also determines whether collections of fluid are present in a bursa, although greater trochanteric bursitis is often not seen on MRI. Iliopsoas bursal collections can be visualized because they tend to be larger."

medscape.com/answers/87169-...

MRI is invaluable for ruling out other causes - but if it is trochanteric bursitis it may miss it. And that would have been my first line thought.

However - are they entirely sure there isn't something else going on? Nighttime pain that improves on getting up and moving is typical of anklyosing spondylitis which can be confused with PMR in its early stages. Also, it responds to NSAIDs and less to pred. Did the MRI include the spine and sacroiliac joints?

[Griggser in reply to PMRpro]

The scan was just the hips as they were looking to rule out Avascular Necrosis. I do get confused with all that’s going on. Yes NSAIDs seem to help. However if I drop below 12mg of pred my symptoms get worse. Add into the mix that my CRP was normal on my last blood test, the first time since diagnosis! I’ll mention anklyosing spondylitis the next time I see the rheumatologist. Thanks for replying, helpful as always😃

[PMRpro Ambassador in reply to Griggser]

But above all - mention trochanteric bursitis!

[SheffieldJane]

I had a quick skim read of your old posts and it struck me how proactively you have tried to manage this disease. I also noted that hip pain has been a feature and was mentioned by you a year ago. I also read your helpful link on inflammation leading to depression ( thanks for that it was pertinent to me today). I wonder if you have ever read your old posts that outline your epic battle. Sometimes truths and perspective emerge when you see the whole thing as a narrative. I can sense your frustration following the MRI Scan - not that you want anything serious - but you need an explanation and appropriate treatment.

As usual, PMRPro’s theory is a good one. I would try that avenue. Wishing you a second wind and a solution. Kind regards. Jane.

[Pollyanna16]

So sorry to read this Griggser. You might be interested to know we have a talk from the Rheumatology pharmacist at our group meeting 2nd week in October. Hope to see you there.

[Griggser in reply to Pollyanna16]

Once again I won't be able to make it to the meeting as I'll be in Lanzarote😎 Soaking up the Rays and feeling better in the warmth.

[Cyclegirl54 in reply to Griggser]

You enjoy yourself although it may be very hot! A Panama hat definitely required!

[Pollyanna16]

How could you? 😢😎 Do hope it makes a difference & you get to the bottom of this hip pain.