How to treat RA-positive joint pain and swelling?

Question

Hello doctor,

My mother, aged 55, has been suffering from rheumatoid arthritis (RA positive) for the past four years. She also occasionally develops red spots on her skin. We have consulted many hospitals, but there has been no improvement in her condition. Various medicines have been prescribed, but none have been effective. She experiences pain throughout her body, persistent fever, and swelling in her joints. When Medrol is given in a high dose, the swelling reduces, but the pain remains severe, and there is no significant relief from her overall symptoms.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

I have reviewed the reports, and I understand that you have already consulted several rheumatologists.

I noticed some confusion regarding the diagnosis. At one hospital, the condition was labeled as systemic lupus erythematosus (SLE) (a chronic autoimmune disease causing inflammation and damage to multiple organs), while others have been diagnosed with rheumatoid arthritis (a chronic autoimmune disorder that primarily affects joints, causing pain, swelling, and potential deformity). This discrepancy needs to be clarified.

Regarding the pain, it could be caused by persistent joint inflammation, fibromyalgia (a chronic condition characterized by widespread musculoskeletal pain, fatigue, and heightened sensitivity to touch), or SLE. A thorough physical examination would help determine the exact cause. Either way, we need to adjust the therapy for better outcomes.

Additionally, I suggest conducting recent blood tests to assess the level of inflammation and overall condition. These results will guide us in managing the disease more effectively.

A follow-up consultation would be beneficial to evaluate the current activity of the disease. Please consider bringing the patient for an in-person assessment.

I hope that you get your answer.

Please let me know if you want some help.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I can understand your concern.

The reports appear to be fine. The doctor has also labeled the condition as systemic lupus erythematosus (SLE). You can try the recommended treatment for some time and observe if there is any improvement. If the symptoms persist or do not improve, it would be advisable to bring her in for a follow-up consultation.

I hope that you get your answer.

Please let me know if you want some help.