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HomeAnswersRheumatologyseronegative arthritisIs it fine to get Kenacort injection for unbearable joint pain?

I have seronegative arthritis with unbearable joint pain in the night. Please help.

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At June 9, 2020
Reviewed AtJuly 18, 2023

Patient's Query

Hello doctor,

I have seronegative inflammatory arthritis with ANA positive. I suffer from joint pain, especially at the right knee shoulder joints MTP IP joints. It is unbearable at night for the last three months and is relieved with NSAIDs (non-steroidal anti-inflammatory drugs). The patient cannot walk and is chairbound with in situ catheters for more than four years. I am taking Ultracet if the pain is unbearable, a few days back I have taken injection of Kenacort 60 mg IM on the advice of a rheumatologist with some relief, but again pain resurfaced. Apart from that patient is on Apixaben 2.5 daily, Mirabeg 50, Soliton 20, Donezepil 5, and vitamin C 1 gm daily. I do not have BP and DM issues. I am taking an inhaler Laba with corticosteroid for a long.

Hello,

Welcome to icliniq.com.

I have gone through your reports and history (attachment removed to protect patient identity). There seems to be some inflammation going on in the blood reports and with a diagnosis of previous arthritis, it looks like it is coming back again. Does the rheumatologist not want to start on Methotrexate or any other DMARD? Are you not on any medications for the CA prostate? Are any other symptoms of oral ulcers, dry eyes, or dry mouth? Do let me know these queries and I would advise you further.

Thank you.

Patient's Query

Hello doctor,

The rheumatologist planned to start DMRD after C3, and C4 complement reports. CA's prostate is in remission. No medication or any intervention from 2009. No oral ulcer or dry eyes. Sometimes dry mouth but maybe for Soliten and it is not significant. Was it fine to give an injection to Kenacort? Until C3 and C4 report comes should I continue with NSAID? Can it affect his kidney function? He was diagnosed with severe OA in both knees.

Hello,

Welcome back to icliniq.com.

There is a lot of swelling in the pictures (attachment removed to protect patient identity). Yes, Kenacort (Triamcinolone) is to go for as it is the only drug that will help the current state. But I feel he will need a short course of oral steroids for three to four weeks to help him relieve his pains. ANA (anti-nuclear antibodies) is positive but it looks more like seronegative arthritis only. My suggestion will be to start tablet Hydroxychloroquine 200 mg twice daily and Folitrax 15 mg once a week. That will cover ANA as well and Omncaortil 20 mg daily for seven days and then taper and omit over four weeks.

I hope this helps.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Naval Mendiratta
Dr. Naval Mendiratta

Rheumatology

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