Interesting visit with Rheumy - fat not edema!

[krillemy]

I had a very interesting visit at the Rheumy e few days ago. We discussed MtX that I have started, and I have very good effect now after 4½ month, so he will increase from 20 mg to 25, and start decreasing prednisolone. I am on 12,5 mg now so down to 10 mg, and then very slowly 1,25 mg every 6 weeks. Goal is 5-7,5 mg.

But I complained that the bumps on the outside of my ankles where not coming down even though the overall swelling of my feet now allows me to fit into nicer shoes 😊. So, he agreed to make an ultrasound and guess what! It was NOT edema, but lipoma (fat tumors). He and I was very surprised as a scanning had been done in 2021 by a professor at the Hospital that found “well defined subcutaneous edema “ and then concluded that I had no signs of Rheumatic disease….

So - now I consider having surgery to remove them as they hurt when I walk longer distances, and neither the MtX nor the pred. will do anything for them.

Does anyone have anything similar?

I can´t find that lipomas are seen symmetrically seen very often, so it is strange. But strange is my condition´s middle name my Rheumy says 😉

[Koalajane]

I have one on the inside of my elbow. It doesn’t cause pain so they don’t want to operate

[krillemy in reply to Koalajane]

Same here in DK, but these do cause pain, so I will try when down in prednisolone

[PMRpro Ambassador]

How - strange ...!!!! I wonder what initiates a lipoma - not sure it has ever been mentioned on the dermatology programmes I watch!

[krillemy in reply to PMRpro]

Maybe it was edema ones..? I do have bumps between my knuckles on the hands, and that is edema... they do not know why... part of PMR maybe they say

[PMRpro Ambassador in reply to krillemy]

No - the programme I watch is removing lipomas and other such things in all their glory. I haven't heard of lipomas along with PMR - but have heard about oedema in RS3PE syndrome which does occur with PMR quite often.

[MiniSpec in reply to PMRpro]

Sounds like you've been watching Dr Pimple Popper! I must say that I'm a fan, and find the removal of the lumps absolutely fascinating to watch. Mind you, I wouldn't want to be there, as some of them have quite and aroma when opened.

[PMRpro Ambassador in reply to MiniSpec]

No - never watched that, too American for me, There are two UK ones, Skin A&E and another, One of them has THE NHS skin queen and she is so lovely. She does more than just popping pimples though - sorting out severe psoriasis and other obscure diseases the local NHS dermies have failed to identify and manage over years.

[krillemy in reply to PMRpro]

Hi again - I may have RS3PE as well with the swollen back of my hands. It has been mentioned, so interesting what you write. The surgeon found the bilateral situation strange and also said that it is diffuse lipoma, and therefore more difficult to remove as well as close to the joint, so I am off to the orthopedic surgeons. He also said that the lipoma slowly grows back - have you heard this as well?

[PMRpro Ambassador in reply to krillemy]

According to skin A&E, if a bit of the lipoma material is left it MAY grow back so it is crucial that they manage to get it all out and that isn't easy, especially when it is a diffuse form. The same applies to cysts - if any of the capsule is left behind, it will regrow.

[krillemy in reply to PMRpro]

Thanks - will focus on the MAY

[Koalajane]

I went to the tumour department at the Orthopaedic Hospital in Oswestry and was surprised to find it busy with patients with fatty lumps. A friend at work also had one. I thought I was unique!

[krillemy in reply to Koalajane]

They are quite common yes, both my husband and daughter have had several. But solitary, not symmetrically on both sides of the body...

[5lupins]

I have a lump on my inner forearm which is sore if knocked and hurts. Cyst on nerve was diagnosis for a few years, but when advised to have ultrasound and then mri it was found to be a nerve sheath tumour. Another mri to confirm benign next month. Would normally remove but it is on the arm where lymph nodes removed for breast cancer so i don’t want to risk surgery. Also surgery could cause worse nerve damage and my other hand is damaged.

It is always worth checking out but often nothing to worry about.

[krillemy in reply to 5lupins]

Thanks 5lupins. I am sorry for your situation, I hope a solution is found that works for you. My Rheumy actually wrote me that he would look further into it at the next consultation, to be sure what it is, so I will let it rest for the next 3 months

[5lupins]

I am ok with it as I have a good hospital and not in much pain. Take care Jen

[herdysheep]

I have had lipomas develop on my back near shoulder blades since pmr started but as that was quite some time ago, no idea if it is related. One reduced of it's own accord. Another grew alarmingly lately, which has been investigated. It does cause discomfort but less than other things at the moment. Having had a big weight loss and never been that heavy, it feels a bit insulting to have fatty lumps develop!!!