knee pain

[SandyBoots]

I have yet another question. I am not on prednisone at the moment and do not have any pain to speak of in the areas where it all started - shoulders, pelvic girdle, thighs, but do have a nagging discomfort in my knees and wrists. My neck sometimes too, but I know I have osteoarthritis in my neck. My Rheumy swears that knee pain is not associated with PMR and that it is probably osteoarthritis. I beg to differ since the pain is bi-lateral. I also read the attached article about capsular knee involvement and PMR. academic.oup.com/rheumatolo...

Do any of you also have knee involvement that you are fairly certain is related to the PMR and not osteoarthritis? I am concerned that inflammation is running rampant in my body!

Thanks for your thoughts.

[PMRpro Ambassador]

The first time I saw a rheumy about hand and knee pain, a year or so after the first PMR symptoms appeared, she insisted it was OA, she could "feel it" in the knee. No imaging was done of the knee though she did order hand x-rays - I never heard the result. The knee pain came and went - and went altogether with pred a few years later. Thirteen years after that consultation the knee pain returned and my GP here immediately ordered an x-ray - no sign at all of any OA and a few weeks later the pain resolved, I may have upped the pred a bit, I can't remember. However - no, it wasn't OA was it? I also have wrist pain - and it is always the first sign of a flare setting in.

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Za

[Hidden]

Good morning my PMR started in my right knee and a couple of weeks later manifest itself in the left knee as well the pain spread down both legs. Gradually my symptoms worsened thighs shoulders etc. Good luck

[Lochy]

Knee pain was not one of my original symptoms but it appeared around 2 years into my PMR journey. Having been a very active person for most of my life I already had niggles in my right knee from squash and running so assumed when pain and swelling appeared it was due to residual damage from life and general ageing. My rheumatologist claimed knees were not a common symptom of PMR so other things were suggested OA, inflammatory arthritis etc. I didn’t really care, all I wanted was for my knee pain to be gone and my mobility returned. After fluid drained, several steroid injections in my knee and different drugs introduced I decided to get an MRI privately. The orthopaedic consultants report said the large effusion and bakers cyst were the source of my pain. Otherwise my knee was pretty good for age and stage considering previous activity showing no signs of OA and only a couple of small meniscus tears but nothing that would make them treat my knee. He explained that once the swelling was gone I’d be a lot better. He’s correct, I am, but my knee niggles but hasn’t swollen for over six months and all I can do is keep my fingers crossed it doesn’t! No one has been able to give me an answer as to why my knee swells. No other joints swell. I continue to taper slowly, currently on 6.5 mg after 5 years since diagnosis. I have ditched all the other rheumatology drugs and now only take prednisolone……..oh and Adcal and various supplements! I’m far more active again and have even played a few holes of golf which has been a delight. My body complains for a few days after but I put it down to exercise not the PMR. I hope I’m right. Knees seem to be a mystery to the rheumatologists but as we can see on this forum there are plenty of us with knee problems.

[PMRpro Ambassador in reply to Lochy]

Give your rheumy some bedtime reading:

pubmed.ncbi.nlm.nih.gov/238...

High frequency of capsular knee involvement in polymyalgia rheumatica/giant cell arteritis patients studied by positron emission tomography

I don't mind them not knowing something but I do mind when they don't check before pontificating ...

[Lochy in reply to PMRpro]

I downloaded that paper last time you quoted it. Unfortunately my face to face appointment has been changed to a telephone call next month. The long gaps between appointments makes it hard to stay on the case! I do quote quite a lot to her so will keep this one up my sleeve.

[SandyBoots in reply to PMRpro]

agree! I actually sent the same article to my rheumatologist yesterday. I really don't appreciate the arrogance of some Physicians when they assume that their patients are not going to research and advocate for themselves.

On another note, I feel so bad for the large numbers of people that don't have the resources or ability to do the "leg work" to advocate for their health.

Having retired from public health after 29 years it makes me frustrated that some physicians aren't willing to be more invested in staying current and understanding conditions diagnostically and from a treatment perspective. I will stop now, although i could go on and on.......

[PMRpro Ambassador in reply to SandyBoots]

We could probably have a glorious rant

[winfong]

Mine started with knees and hips, with shoulders coming later