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MRI showing edema and arthritis in knee and extremely difficult to stand due to polymyalgia rheumatica

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Posted on Thu, 26 Dec 2013
Question: I have extreme pain in my lower legs, knees, ankles, and right arm/elbow for the past 2 1/2 years+. I have been diagnosed with PMR. I have extreme difficulty standing up. I have to push/pull myself up to stand up from a sitting position. I have seen a rheumatologist, and a neurologist. The blood tests show elevated inflammation in my system. I have had MRI on my back which came back as normal with a little arthritis, one in my right knee in May of 2012 which showed edema, some arthritis, cartilige damage, and a trauma injury in a muscle in the back side of my knee (this is when all this pain started). Dec. of 2012 my left thigh/knee muscle "popped" and now my left side is worse than my right side. Doctors have "drained" my knee without success, and in July 2013 put me on prednisone with tylenol for arthritis 4 x's and day reducing the prednisone over time I am currently taking 4 mg of prednisone. I am still in extreme pain and it is difficult to "function". In Nov. 2013 I had a muscle biopsy- looking for possible MS?- the results came back and showed the muscle as being normal. I do physical therapy as tolerated, and sit in a hot tub at times to help eliviate the pain. Exercise seems to make my condition worse. Any suggestions would be greatly appreciated. As I reviewed the health query, my pain has been for the past 1 1/2 years+. I am also suffering with fatigue and I have a CPAP at night due to not getting enough air through my nasal passages causing me to breath through my mouth and snore causing my throat to swell and not be able to talk and difficult to swallow.
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Answered by Dr. Dr. Shruti Rijhwani (17 hours later)
Brief Answer: Follows. Detailed Answer: Dear Madam, Thank you for posting your query on XXXXXXX Well looking into your query I will like to tell you that you have got multiple issues . I can well understand the agony you are going through . You have been treated rightly for PMR as steroids are the only treatment available with us for this problem. Your knee effusion is unrelated probably you are having osteoarthritis knee that is being complicated by effusion . One more thing is that since you give a history of IBS , Anxiety , depression you may have developed Fibromyalgia which is a very common accompaniment of these disorders and may be responsible for your extreme fatigue , mood changes , depression etc. You can take a paracetamol for pain relief if required as it is a safe drug and has got minimal side effects but after consultation with your treating doctor as he remains the best judge of your situation . Probably starting Fluoxetine is going to benefit you a lot . Lose weight in case you are overweight . kindly consult your doctor , get a recent blood test and discuss the issues we have pointed out . May be he will be able to make some changes . Take care. Dr Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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MRI showing edema and arthritis in knee and extremely difficult to stand due to polymyalgia rheumatica

Brief Answer: Follows. Detailed Answer: Dear Madam, Thank you for posting your query on XXXXXXX Well looking into your query I will like to tell you that you have got multiple issues . I can well understand the agony you are going through . You have been treated rightly for PMR as steroids are the only treatment available with us for this problem. Your knee effusion is unrelated probably you are having osteoarthritis knee that is being complicated by effusion . One more thing is that since you give a history of IBS , Anxiety , depression you may have developed Fibromyalgia which is a very common accompaniment of these disorders and may be responsible for your extreme fatigue , mood changes , depression etc. You can take a paracetamol for pain relief if required as it is a safe drug and has got minimal side effects but after consultation with your treating doctor as he remains the best judge of your situation . Probably starting Fluoxetine is going to benefit you a lot . Lose weight in case you are overweight . kindly consult your doctor , get a recent blood test and discuss the issues we have pointed out . May be he will be able to make some changes . Take care. Dr Shruti