Suggest treatment for thyroid nodule
Thank you for writing on health care magic
Well your diagnosis of polymyalgia rheumatica looks more or less confirmed and you have had a good response to steroids.
As for the thyroid nodule, yes I agree you need to get it evaluated. It can be an autoimmune condition considering the autoimmune nature of polymyalgia rheumatica. But I would recommend you getting an ultrasound of the thyroid along with fnac of it. The fnac will.give us a brief clue on if it is something beningn or malignant. Also you can examine yourself for any lymph nodes arising in the neck or axilla region. You can tell it to the doctor concerned too. So he shouldn't miss out on anything
Don't be worried about it. But yeah I won't suggest delaying it any further.
Feel free to ask me for more queries
I would be happy to help out
Cause of thyroid nodule
The lymph nodes are a bit unlikely to happen due to PMR. Yes they can subside with prednisolone as well, as steroids suppress anything inflammatory or reactionary lymph nodes. The pain you are describing along with raised ESR could be very well attributed to PMR and less likely due to thyroid nodule.
But yes, i would want to rule out anything suspicious related to thyroid especially if they come with lymph nodes. Try and arrange FNAC the same day of ultrasound,so you can proceed with the next step without getting much time wasted. Also do ask for a Radio iodine uptake. The thyroid levels can be normal as they get affected only when the gland gets affected.
Dont worry, it will all work out. For all we know it is just a benign thing.But yes, as doctors we do keep the highest suspicion which will benefit you.
Do let me know for more queries
Wpuld the reduction results be any different with rheumatoid athritis.
Both my doctors are away until XXXXXXX 8
Monitoring of PMR
Sorry for the late reply.
For PMR, we need to look at your symptoms: 1. Increased pain over the shoulders, thighs
2. Duration of Early morning stiffness 3. Your ESR levels.
If the pain and stiffness begins to increase or the ESR remains persistently high on tapering the steroids, we may need to continue it on the same dose at which the effect was good. But yes on long term basis, we will have to add a steroid sparing agent. But that is only after 6 months to 1 year of treatment.
In Rheumatoid Arthritis, at our place we normally don't use steroids for long as patients get dependent. We prefer the other Drugs over steroids.
Hope the information has been useful
Do let me know for more queries. Would be happy to answer it
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