Update on Hips 12 "So Confused": Osteo or Rhumatoid

Hips12

Hi everyone, apologies for not coming back sooner but have been struck down with all the bugs that have been doing the rounds esp sickness bug which lasted 3 weeks!!!

I hope this finds everyone well and/or coping as best they can.

So to update my previous post re: confused as to what kind of arthritis i actually have.

On 4th March i saw the Rheumotologist and i have to say i am so delighted with how thorough her examination was.
I didn't feel rushed, was able to tell her in depth how i have been feeling and the symptoms i have.
After examining me, which was painful as she had to see how much range my joints have, she sent me for bloods..10 vials were taken, and then onto xray for neck, spine and hips.
I wasn't expecting to receive a copy of her assessment after only 6 days so was happy to receive it when i did.

Unfortunately this didnt include the blood or xray results yet, but her assessment of my condition was as follows.

Schrimers: 4mm ( measurement of dry eyes )

Facet Stress positive

Limited movement lumber and cervical spine

Heberdons Nodes

Mild onycolysis on nails

SLR 50 degress bilaterally reduced to hip movements

Tender points around cervical and lumbar spine

Impression: Likely OA with SICCA symptoms (sicca symptoms same as sjogrens but not autoimmune)
No evidence of Inflammatory Arthritis or connective tissue disease

So providing the bloods come back normal, i will remain under my
gp.

There were plan notes included, things like asking my doctor to prescribe eye drops and to increase my dosage of amitriptyline to help me sleep.

I have had a quick Google of some of the terms used but am eager for the xray results to see how much damage there is.
I will probably have to wait until my follow up appointment with my gp for more clarification, and the bloods and xray results.

So in conclusion, unless the bloods show otherwise, i definately have Osteoarthritis.

Any further light anyone can shed on the assessment would be much appreciated.

Thanks for reading.

Hips 12

barbara12

Hello Hips..glad you are at least getting some answers, I have been there and still am in a way, my bloods come back with no inflammation , but apparently this can happen sero negative I think was in my last letter..but they have not made up there minds..the first rheumy I saw said it all pointed toward Ankylosing spondylitis, must say your letter sounds very similar to mine even down to the nails, but not the dry eyes..hopefully it will be clearer when you have your follow up...

Hips12

Thank you Barbara, and sorry to hear that you are still in the same boat as me.
It is very frustrating as we know our own bodies and what doesnt seem right.
The dry eyes, mouth and "lady bits" are symptoms of sjorgrens which in an autoimmune problem, which is what led me to think my arthritis might also be autoimmune, but the physical assessment appears to have ruled that out.
I have had 3 negative blood tests in the past, so i asked my gp if she would send me to the Rheumy so i could find out once and for all what i actually have...esp as the only xrays in the past have been right knee and both hips which show moderate and severe deterioration.
However i do think she is correct in assessing me as having Osteoarthritis and i am sure the blood tests will confirm this, but i am interested in what damage the xrays show, especially in my neck and spine as i am in a lot of pain just standing these days and i don't think we have reached the stage of being able to be totally rebuilt like the Bionic Man yet lol so i need to know what the future holds.
I can't reiterate enough how very thorough i found the consultant so i am happy to accept her findings.

I hope you manage to get some answers eventually Barbara, it has taken me 4 years to get to this stage.
I know we are not the only ones who have struggled with the confusion of what exactly it is that is wrong with us, having read other forum members stories.
(I will look very foolish now if the bloods come back positive after all this, haha, but i am pretty confident they won't.)

Hips xx

dreamdaisy

I'm one of the happy campers with a creaky foot in both camps, my rheumatologist deals with my PsA (a sero-negative form of auto-immune) and my GP the resulting OA. If it is determined that yours is OA then the rheumatologist will not be dealing with that, just the possible Sjogren's. OA is not diagnosed by bloods and it comes under the remit of the GP.

With around 300 kinds of auto-immune inflammatory conditions diagnosis can be tricky unless one presents with the exactly the right symptoms in the correct places and the bloods come back sero-positive (i.e. rheumatoid factor is present). I didn't and it took some years from my general label to be altered to PsA; the meds, however, remained the same so I got precisely nowhere . It's a confusing world, yes? It's good that the lady you saw was so thorough and gave you the time you needed to explain things. DD

Hips12

Thanks DD, i know you are in the unfortunate position of suffering from both types of arthritis, and i really feel for you as one on its own is bad enough.
I hope you are not doing too badly at the moment.
The reason i am sure it is Osteo now is because of the physical examination, i don't have any of the "usual" symptoms of RA eg the smaller joints being affected, or heat and swelling in the joints.
I realise it is not an exact science however hence requesting the assessment from the Rheumatologist.
As 3 lots of bloods have ruled out any sign of Rheumatoid factor i have accepted that it is just the wear and tear kind so will just stay under the care of my GP, who has been great by the way.
Goodness knows why 10 of those vials were required, but as i said she was good and thorough in her examination and i cant expect more than that.
I had no idea that the symptoms of sjorgrens can also be labelled as "sicca" so even that appears to rule out any autoimmune disorder.
I think i will have to accept this 4th lot of bloods as final, although obviously judging by your experience the occassional blood test in the future may still be a good idea.

Thanks, as always, for your input DD, you have always been so helpful to me.

Hips xx

dreamdaisy

I don't think I have but thank you anyway! There are a number of tests that she could have requested, inflammatory markers, iron levels, Vit. D, kidney and liver function, neutrophils etc. etc. etc., you name it I'm sure there's a test for it! My best guess is that she is trying to get as much information as possible about what is going on with you so as to specifically rule things out as opposed to in.

Currently I am enjoying a really grim time so life ain't much fun at the moment. Never mind though, it is what it is, it will do what it will do and there are still things to be thankful for - it's just harder to remember what they are . The fact I can make myself a cup of tea is one so that is what I'm off to do. Keep us updated as and when you hear something, yes? DD

rayray

Hi Hips!

I am in a very similar position to you and have just had inflammatory arthritis ruled out even though I have had psoriasis confirmed. I have very limited movement in my spine which has always been the case despite being super ftr when I was younger. Lots of other joint issues now confirmed as osteo. I have now put it all down to having not so funny bones!

I am sorry but I can't remember your situation with your hips but just in case: if you are still fairly young have you seen a hip consultant who specialises in hip problems in younger folk?

After increasing pain in my hips I was found to have badly formed hips due to FAI along with a few other issues in them. I had a THR in one (after two previous hip surgeries) and an arthroscopy on the other. I had never heard of FAI until a hip surgeon at the local hospital told me that was what I had and referred me for treatment. I went from being permanently on crutches or scooter to walking our dog daily which I still can't quite believe. Walking is one of the few things I can do due to neck problems but that is another story...

Hips12

Dreamdaisy: sorry to hear things are grim for you at the moment.
I hope it will ease off soon.
Of course i will report the further findings as i get them, but it may have to wait until i see doc on 1st if i am not cc'd into the results.

Ray-ray
Thanks for your input and thoughts.
I hope you are not doing too badly at the moment.

It has taken 4 years to get to this stage but i am glad i persevered and got the Rheumatology appointment.
When you are consumed with pains everywhere you just want to know what the hell is going on.
I am just so glad she gave me a thorough examination even though i think she knew it was Osteo, from the referral letter from my gp.
I will be glad to get the results of the bloods and x-rays as they
will show how far things have progressed at this point in time, and rule out autoimmune arthritis too.

I will pos my results andany further update as and when i get them.

Thank you again.

Hips 12 x