Knuckle and Knee pain

[PPower]

My partner is down to 5mg prednisone, has been at this for 6 years or so and now has pain and swelling in one hand’s knuckles as well as her knees. Last time she saw the rheummy who we dislike, she had only one knuckle swollen and painful and he said he wants to start treating her like she has RA. Huh? He hates that she’s still on prednisone and I don’t think he treats many with pmr. We’ve asked for a lab slip to check her crp and sed rate. Could it be some kind of arthritis, her pmr, or RA or??? Any thoughts would be appreciated.

[piglette]

Magnetic resonance imaging (MRI) and ultrasound may help diagnose rheumatoid arthritis and could check for other things. Like PMR it is a matter of discounting other things.

[PPower in reply to piglette]

Yes, I think some diagnostic tools should be used and not just, I’m sick of treating you for pmr and continually giving you prednisone so let’s move on to another diagnosis. So frustrating. Thx for listening.

[piglette in reply to PPower]

I really do despair of some people who say they are medically qualified.

[PPower in reply to piglette]

oh, me too!!

[SnazzyD]

Do you have a choice of doctor or is this it? Have they done any other blood tests to rule out other things? Gout even? Do you feel able to ask what their reasoning is to say it’s definitely RA, other than it’s the only other disease they know? Perhaps leave out the last bit 😏

[PPower in reply to SnazzyD]

We do have a choice but

[PPower in reply to PPower]

… it seems impossible to find someone else.

[Seacat30]

My grandmother with RA had horrific swollen ankles but her hands were OK. My grandmother with OA had terrible swollen knuckles and could hardly use her hands.

[PPower in reply to Seacat30]

interesting…

[PMRpro Ambassador]

Or it could be as simple as osteoarthritis or other causes of swollen knuckles. What diagnostics has he done? Is a change of doctor an option?

[PPower in reply to PMRpro]

He’s done nothing else. She can switch to another practice but it’s difficult to find another. I wonder if nobody wants to be a rheumatologist…

[PPower in reply to PMRpro]

I’m just remembering that she had X-rays in October and they showed arthrosis in her knuckles, aka OA. He really should get another career…

[PMRpro Ambassador in reply to PPower]

I have a theory that many go into rheumatology because they think it is a doddle, no life or death decisions, no night calls, weekends off ... It is a fantastic specialism and is really exciting if you are into research but that takes up the evenings and weekends. So they go into practice and soon become disillusioned because they went into medicine and were taught they are knights in shining armour who ride to the rescue and CURE their patients who are eternally grateful. But in rheumatology there are no cures - their job is to make life for patients as good as possible and sometimes that just doesn't happen and they have to see their patients deteriorate over time. So they grow to hate their work but it is too late to change ... Sad - and we sometimes are on the receiving end of such disillusion,

[Nextoneplease in reply to PMRpro]

Ouch!!!! This rings only too true of some 😟Thank goodness there are still some interested ones around 😊

[Rachmaninov2 in reply to PMRpro]

I think I have detected a lack of interest and boredom.

[PMRpro Ambassador in reply to Rachmaninov2]

I was with my rheumy for the best part of an hour yesterday and he commented how he enjoyed having a patient he could talk to about studies, He was amazed I'd already read his paper! Like Sarah Mackie he's a born "True Detective" as my friend on the LupusUK forum describes them

[Rachmaninov2 in reply to PMRpro]

That sounds like true communication between equals, as it should always be. Unlike many of my consultations. ☹️

[PMRpro Ambassador in reply to Rachmaninov2]

I said to him yesterday, I can't go back to the UK!

[PPower in reply to PMRpro]

You're in Italy, right? Maybe we need to move! Used to visit our daughter when she lived there and we seriously fell in love with Italy.

[PMRpro Ambassador in reply to PPower]

In South Tirol, an autonomous German-speaking region in the north. Not as easy for you as it was when I came here though

[Rachmaninov2 in reply to PMRpro]

That’s that then, mind made up. It all boils down to quality of life, what is most important to each of us. Health would be the priority for most.