I have ankle and calf muscle pain. Could it be RA?
Hello doctor,
I am a 38-year-old male, suffering from RA from the last two years and recently started the treatment with an orthopedic doctor for AVN of the hip. I have been told by my orthopedician at icliniq to consult a rheumatologist for my ankle and calf muscle pain, and for my RA medication and cholesterol levels. The X-ray of the left leg had the problem of soft tissue noted. Please find the X-ray of the ankle and that of the hip and knee attached. I have been on RA medicines such as Imutrex 20 mg weekly, Folvite 5 mg daily, Bio D3 strong daily, Uprise D3 60K monthly once, Pirox 20 mg at night, and Osteofos 70 weekly for hip AVN as suggested by my orthopedic.
I was on biologics one year back - Etanercept 50 mg weekly for three months. Please suggest RA medications and a medicine for my ankle soft tissue which causes me pain and difficulty in walking too. I have started Gabapentin 300 mg from today for five days as prescribed by the orthopedic. I am taking Combigan and Dorzox-T eyedrops for glaucoma in the left eye. The X-ray of the hip states that the bilateral femoral heads appear sclerosed with diminished joint spaces and irregular surfaces of femoral head. However, the shape of the bilateral acetabular cavities is maintained. The X-ray of both the knee states that joint spaces are reduced. Osteophytes are noted at the patellar and tibial surface. The patella-femoral space is diminished. The X-ray of the left leg with ankle states no significant abnormality detected. I have pain in the calf muscle and ankle tissue along with tingling (pins and needles) in both the feet. Please suggest proper medication for RA, ankle pain, calf muscle pain and for cholesterol.
17 Jan 2024 - 1 min read
I have severe pain in my shoulder and neck. Please suggest a treatment.
Hello doctor,
I am a 40-year-old female. I have been having pain in the shoulder many times, which extends from the neck to the whole left hand. It pains me a lot. I have been suffering from this pain for more than six months. It pains me so much that I have no control over my body and get tears. Please help me get this pain out of me.
19 Dec 2023 - 1 min read
Can biological medications be started after an intestinal repair surgery in a 21-year-old female?
Hi doctor,
My daughter, aged 21 years, was diagnosed with PAN 11 years ago. And she was treated with Omnacortil, Azoran, and Cyclophosphamide. After four years of treatment, the disease went into remission, and since then, she has been drug-free. However, three years ago, she complained about severe abdominal pain, and the rheumatologist started her on a steroid and Azoran, but with no relief. And she got perforation of the intestine after a few months of the medication. So the repair surgery was done, and now she has been discharged from the hospital, though the wound has not healed completely. And during this treatment, she was tested for DADA 2 and was found positive for it. So now the doctors are planning for biological HUMIRA. But the dilemma is whether it should be given now or should we wait for the wound healing? Also, her recent laboratory reports showed ESR 35 mm/hr and CRP 1.5 mg/L.
Please advise.
12 Oct 2023 - 1 min read
I have restricted movement and severe deformities in many joints. Please help.
Hi doctor,
I am a 27-year-old. I have had JRA since the age of six. I have been wheelchair-bound since age nine. I have restricted movement and severe deformities in many joints. I am not on any medication except Brufen, a painkiller. I have stopped treatment for many years as there was no progress. Will light physiotherapy or stretching exercises help in the movement and flexibility of stiff joints?
10 Oct 2023 - 1 min read
There is knee inflammation after stopping steroids. Why?
Hello doctor,
My daughter (4 years old) had an eye injury around seven months back. She is now diagonised with granulomatous panuvietis. I have consulted in person around six opthalmologists and they have told that it is due to eye injury. However, one of them wanted me to go for auto immune tests just to rule that out and asked me to consult a rhemutologist as well. My daughter did not have any joint pains or any other problems at all. It was only eye inflammation. We did all the tests including CPR, ESR, RA factor, ANA and every possible test. Tb also, jaundice LFT, X-ray, B-scan, C-scan. All of them are normal. Only that she has cataract in eye due to inflammation which opthals told that it is due to injury as it was ignored and not treated. Later, the doctor prescribed her Deflazacort 18 mg.
She was on medication for three weeks and we were shifting our house to another city. She suddenly fell ill due to hot weather. Physicians asked to stop steroids immediately and the opthal doctor also asked us to go ahead with them. She was ill only for a day. Next day, we shifted back to our native which is much cooler and she was absolutely fine without any medications. However, after a day, she started having severe joint pains only in her knees. Since we were in a village,we could not take her to doctor. After 4 to 5 days she started getting swelling in both the knees. When we rushed to doctor, they claimed it as autoimmune. Now we are in confusion. Till she was taking steroids ,she was fine. Rather, even before she was on steroids also, she had no problems. However, after pulling off steroids, she has inflammation and there is no evidence of why this inflammation has occured, if it is autoimmune. As all her reports are normal and only her joint inflammation which we believe is due to the medicines that she took, can anyone conclude that its autoimmune? Does any knee inflammation in a normal person means autoimmune? Is inflammation in any part of the body related to only auto immune diseases. Is there no other reason? Now the doctor is saying that she has to be on immunosuppressants for two years. Is this only because she has inflammation in leg which also occured due to withdrawal of steroids and there is no other reason?
03 Oct 2023 - 1 min read
