Sjogren's flare with jump to RA?????

[ktfabian]

I've been in one of my more intense flares since surgery in Oct. 2008.  It's really just hit like a ton of bricks.  On Monday, I noticed my right knee was slightly swollen, but didn't think much of it.

It was a bit sore yesterday, so I called my family doctor and she ordered a doppler scan to see if there were any clots.  I was told there weren't.  Last night, I was one of several hostesses at a Christmas party for children of members of the military. I wore my normal sneakers.  It was sore going into the event,by the end,  I felt like someone was shooting railroad  spikes into the center of my kneecap before the evening was over, and I had pain radiating down my leg to my foot and up my leg to my groin. 

This morning, my knee looks like it could be 2 times the size of the left one and the pain isn't letting up.  So I called the doctor again, and she said she wanted me to go the ER and let them have a look.  "WHY???" seemed to be the question I got from all of the ER people.  They didn't do and Xray or anything.  I told the doctor about the flare, and after doing what looked like some research on the computer, he came back and said what I really need is an MRI, which they can't do.  He suspects that I've developed rheumatoid arthritis in this knee.  He said it is possible to develop rheumatoid arthritis in one joint during a bad flare of Sjs.  He didn't say if it clears up as the flare settles down.

Has Anyone ever heard of such a thing?  I'm on hold and in a large amount of pain right now and would very much like to cry, but the just gets my husband upset.  They's given me percocet that's twice as strong as the usual stuff, but it isn't even touching the pain.

If you've heard of such a thing, please let me know.  In the meantime, I'm supposed to keep my knee elevated.

Thanks, tracu

[Pooh]

No Tracey,
I haven't heard of this, but that doesn't mean it doesn't happen.  I sure hope the swelling goes down soon and that flare gives up also. 

Take care and try to enjoy the holidays.  Just don't overdo it or you will be in more pain.

Hugs, Pooh

[Scottietottie]

Hi Tracy 

I always thought that one of the hallmark symptoms of RA was symmetry. Of course - I'm not a medic - so I'm probably wrong.

It's certainly possible to have OA and SjS. I got a partial knee replacement because OA had worn part of one joint down to bone on bone and won some of the bone too. It was excruciatingly painful and was swollen as well.

You definitely need an x-ray or a scan to see whether there is joint damage or whether it's inflammation that doesn't include actual joint damage.

Steroid injections helped me initially. When they stopped working - I got the replacement and don't regret it at all!

Take care - Scottie 

[JannaLee]

Wow Tracey,

I've never heard of Rheumatoid occurring on only one side, but apparently that ER doc looked at something that said it can happen.  I'm so sorry for this and completely understand about having to keep a stiff upper lip so as not to upset a delicate husband.

You might need to take a (private) shower or bath and just go ahead and have a good cry.  It will help you (and maybe slow the flare) to let off some of your anxiety.

Honey, I know you are afraid and hurting real bad.  

Janna

[eyeamdry]

It's certainly possible to have OA and SjS. I got a partial knee replacement because OA had worn part of one joint down to bone on bone and won some of the bone too. It was excruciatingly painful and was swollen as well.

Yes, Yes, Yes!  Me, too!  Every word that Scottie wrote applies to me too.  If you're bone on bone, it's painful no matter what and it will likely stay that way until something is done.  ie.  cortisone shot, PT,

As I was reading your post, this is what I was thinking and then I got to Scottie's post and said, yeah!

Lucy

[genko_b]

I have both rheumatoid arthritis and Sjogren's, but the RA came first. They should be able to tell what kind of arthritis you have in the knee using an X-ray; there are characteristic differences between OA and RA. However, it could also be an inflammation because of the flare. You would treat it with whatever anti-inflammatory you normally use, go easy on it when it is hot and/or red and/or tender to the touch, and hope it clears up soon.

I can sympathize with the pain you are feeling.

Genko

[Chana M]

Oh Tracy - my heart goes out to you. 

I agree with Janna that a good cry will do you the world of good.  But I understand that you don't want to upset your husband.  So maybe you could have a cry in private -  I find showering is a good time because nobody can hear you and you can explain away your blotchy face! - and then explain calmly how much crying helps you deal with the stress?

Thinking of you - Chana x

[ktfabian]

Well- My knee and I ended up in the hospital that very same night -and I still know no more than I did then!!!

I called my family doctor (her partner was calling) and told her that I had gone to the ER as directed, but all I had was more pain and a higher dose of pain medicine.  She pretty much hit the roof!  She told me to go back to the ER and tell that doctor that I'm NOT leaving until  they admit me and get the pain under control.  She called the Er and told them we were coming, so I was almost immediately admitted and did get better pain meds.

The next day, my orthopedic doctor's partner came and sucked out about7 of those blood tubes of fluid from one side of my knee and said that they would test that to see what was going on.  I also had an MRI.

The next morning, we got dumped on with snow, and my doctor called and asked if I'd rather go home than sit in the hospital all weekend while the tests were read, which I thought was a great idea.  I probably should have stayed in the hospital.  The Christmas tree was still sitting there undecorated so I told myself I would just do that.  My son who's training to go to Iraq is coming home tomorrow on a 10 day leave and I really wanted everything ready.  Well-when putting the tree up, my husband and older son just moved the recliner that usually sits there into the doorway of the diningroom, which is in the process of being remodeled.   So every time I needed to go into the dining room for anything, I had to move the recliner a bit.  Then there were the dishes that hadn't been done in the 3 days I was gone, and the laundry.  And we have my sister and friends coming Christmas morning for brunch and not only haven't I finished shopping for my boys, I have nothing  for the company, either.

Shall I go on with all that I've had to do since coming home?  I finally gave up on getting my husband to put the empty containers from the Christmas decorations back in the attic, so I put them in my upstairs bathtub.  It doesn't work anyway and you can't tell they're there unless you open the shower curtain.

Now, I need to get my son's bed made and rehang pictures that were taken down when the painting was going on. I guess I shouldn't be surprised that my knee hurts as much as it did when this all started, and every time I sit down in a chair to do something, I fall asleep!

As for the chance of RA - my rheumy told me that I didn't have it when the first two fingers on each hand became nobby and bent (he did an Xray), and my right knee has had a minor blow up like this several months ago, the ortho injected it and it felt worlds better.  So I still don't know what's going on, I just know it wasn't a very nice Christmas present, so if one of you sent it, you can take it back!

If I don't write again before Thursday, my very best wishes for a Merry Christmas, Happy Hanukkah, Happy Kwaanza or whatever holiday you may be celebrating at this time of year.  And my greatest, biggest wishes for a year that finds a cure, ends our pain, and lets us get a good night's sleep! 

[Scottietottie]

Hi Tracy 

Wow - sorry you ended up at the hospital but if they get to the bottom of what's causing the pain - that'll be a plus.

You sounds a sthough you've been overdoing it since you got home though. Tut tut!! 

Hope you get the results through soon. Do let us know. Have a lovely Christmas with your family.

Take care - Scottie 

[missyb]

That is so confusing!  I guess I always thought RA was not something that affected one joint like OA, but an autoimune disease which swollen joints were a sign of that they confirmed with a blood test that was RA positive..I hope they figure that out, however keep in mind that even if it is not RA positive blood test there are over 200 forms of autoimmune arthritis of which RA is just *1*