I am now off Pred since June and feeling good. I need some help regarding my younger sister who has been in hip pain for approx 5mths. Her GP has prescribed numerous pain relief which do not work. She's had x-rays, CT scan with nothing untoward showing. Finally he has done a CRP test which he says is normal. The reading is 5.0mg/L. Is this normal?
The pain is constant and ruining her life. Not sure what else she can do. I'm reaching out to you as you were my lifeline when I was going through my PMR journey.
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Middleton22
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Studies have shown that between 7-20% of patients with PMR do not have raised inflammation markers. So if that is the only reason doctor is not considering PMR, then they are wrong - symptoms first and foremost - and sometimes corrorated by bloods.. not the other way around.
This from one of my posts on subject -
What is normal range of CRP reading?
Adult: less than 8 mg/L
Most patients (90%) without organic disease have CRP levels less than 3mg/L and 99% have levels less than 10mg/L.
Thank you for replying. You were my lifesaver on my PMR journey. I've discussed everything with my sister and someone is phoning her today. She is going to ask for a one week trial of PredGiven her an idea of what to say when they call. Hope she gets them as she's lost her appetite and not sleeping properly because of the pain. Getting worried for her.
The person who reviewed the crp results had the initials ANP after his name but not Dr before his name. I don't think he was a GP?
Is that list meant to switch from mg/L at the top to mg/dL at the bottom? The numbers seem okay.
The following is from: ncbi.nlm.nih.gov/books/NBK4... (2023). I've inserted the conversions on every line, as I know this often comes up.
Interpretation of CRP levels:
Less than 0.3 mg/dL or 3 mg/L: Normal (level seen in most healthy adults).
0.3 to 1.0 mg/dL or 3 to 10 mg/L: Normal or minor elevation (can be seen in obesity, pregnancy, depression, diabetes, common cold, gingivitis, periodontitis, sedentary lifestyle, cigarette smoking, and genetic polymorphisms).
1.0 to 10 mg/dL or 10 to 100 mg/L: Moderate elevation (Systemic inflammation such as RA, SLE, or other autoimmune diseases, malignancies, myocardial infarction, pancreatitis, bronchitis).
More than 10 mg/dL or 100 mg/L: Marked elevation (Acute bacterial infections, viral infections, systemic vasculitis, major trauma).
More than 50 mg/dL or 500 mg/L Severe elevation (Acute bacterial infections).
It has been edited so that the units are now consistently mg/L throughout (it was previously a mix of mg/dL and mg/L). Unfortunately, some of the numbers are now incorrect for the unit used. The correct figures (and a good source) are in my previous Reply: healthunlocked.com/pmrgcauk... where I have given the breakpoints in both units.
Yes, 5 mg/L should be in normal range for the units used. But that doesn't tell you if she has had a lower level previously which would indicate it may be showing a rising trend. A single level is meaningless. And up to 20% of patients with PMR have results that are "in normal range" - but they still have PMR.
That was an Advanced Nurse Practitioner - a highly qualified nurse who has done a load of extra training and holds a Masters degree. Some of them can leave a doctor standing in some questions - but not always! I taught one about GCA and PMR - and she learnt far more from the charity's leaflets than from her lectures!
Interesting what you say about your ANP learning more from the Charity leaflets. My GP almost said the same and a young locum thanked me for telling him something about GCA and directing him to Dr Sarah Mackie !
It was actually the little booklet that the NE charity had developed years ago. ANPs can be amazing support - but they need to know the facts. This one was a close friend of my daughter and mine so we had a different relationship maybe.
Does your sister suffer muscle pain and stiffness upon waking in the morning? Not every PMR sufferer gets it, but it is a crucial symptom in those who do, especially if it lasts over half an hour before easing off.
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