wrist/ankle swelling - symptoms of ra?

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tkmom
New Member


Date Joined Jun 2007
Total Posts : 5
   Posted 6/18/2007 8:49 AM (GMT -7)   
I was diagnosed with ra about 6 months ago, after having symptoms for 1 1/2 years, shortly after the birth of my second child.  I have been taking prednisone, celebrex, and started plaquenil two months ago, but I still have problems with my swollen wrists and ankle.  My joint pain is well controlled with the meds, but this swelling is still uncomfortable and interferes with lifting my kids, doing household tasks, etc.  My rheumatologist doesn't know why I have this fluid build up and pain in my wrists and ankle, and he keeps telling me that they might get better with prolonged treatment on the plaquenil.  Does anyone else have this fluid build up problem with ra?  Is this typical? 

iMarzz
Regular Member


Date Joined Apr 2006
Total Posts : 103
   Posted 6/18/2007 9:51 AM (GMT -7)   
I also have swollen wrists and ankles - tenosynovitis. Has your rheumatologist suggested methotrexate or some other DMARD you are not on any? From everything I have read DMARDS should be started within three months of diagnosis.

tkmom
New Member


Date Joined Jun 2007
Total Posts : 5
   Posted 6/18/2007 11:57 AM (GMT -7)   
I was on celebrex and prednisone for the first several months, and just over two months ago started plaquenil, which is a DMARD.  We talked about methotrexate or plaquenil, but went with the plaquenil.  What are you taking and what are your results?  I was told that I may not get the maximum benenfits from the plaquenil for 3 to 6 months.  Right now I don't think it's doing anything.  The prednisone seemed to help my swelling when I first started it, now the swelling only seems to be getting worse instead of better.  But my rheumatologist doesn't seem concerned about the tenosynovitis.  What is your situation?

Jemima Puddleduck
Regular Member


Date Joined Oct 2006
Total Posts : 41
   Posted 6/18/2007 12:23 PM (GMT -7)   

tkmom,

Hello & welcome to HW. yeah Your symptoms sound a lot like synovitis. My son has RA & PsA and his knees & one ankle are often swollen. He usually has to have them drained of the synovial fluid that builds up. Often he'll get a cortisone shot after the draining.

It has to be very difficult for you coping with RA & a young family as well. I hope you are able to find some sort of relief soon.

I found this, maybe it will be helpful reading:

Synovitis is a major problem in rheumatoid arthritis, in juvenile arthritis, in lupus, and in psoriatic arthritis. It may also be associated with rheumatic fever, tuberculosis, trauma, or gout.

Rheumatoid arthritis involves synovitis. In rheumatoid arthritis, the synovial membrane lining the joint becomes inflamed. The cells in the membrane divide and grow and inflammatory cells come into the joint from other parts of the body.

Symptoms of Synovitis

Because of the mass of inflammatory cells in rheumatoid arthritis, the joint appears swollen and feels puffy or boggy to the touch. The increased blood flow that is a feature of the inflammation makes the joint warm. The cells release enzymes into the joint space which causes further pain and irritation. If the process continues for years, the enzymes may gradually digest the cartilage and bone of the joint leading to chronic pain and degenerative changes.

Diagnosis of Synovitis

In addition to the clinical presentation (warm, red, and swollen joints), the diagnosis may be helped by Synovial Fluid Analysis. This is a test that examines the lubricating fluid secreted by synovial membranes. The test is useful in the diagnosis of some types of arthritis (primarily those caused by infection, gout, or pseudogout).

The test takes about half an hour and usually is done in a physician's office or hospital. No special preparations are necessary. The skin over the joint is cleaned with an antiseptic. Usually, a local anesthetic is injected. Using a thin needle, the physician will withdraw a sample of fluid for analysis, including culture of the fluid if infection is a possible diagnosis, and examination for crystals to diagnose gout or pseudogout.

If needed, medication (usually a corticosteroid preparation) can be injected into the joint space through this needle after the specimen is taken.

Treatment of Synovitis

Synovitis is treated with anti-inflammatory drugs ranging from aspirin to ibuprofen to corticosteroids. Specific treatment is based upon both the presumed cause of the synovitis and the particular patient's response and level of tolerance of any particular medication.

Good Luck,

-Jem

 

-Jem


tkmom
New Member


Date Joined Jun 2007
Total Posts : 5
   Posted 6/18/2007 1:16 PM (GMT -7)   
Jem,
Thanks for the info!  Does hot weather affect your son's swelling?  Mine seems to be getting worse lately and didn't know if it was the weather.  I'm moving and will have a new rheumy soon, so it will be interesting to see what he says about it. 
 
tkmom

Jemima Puddleduck
Regular Member


Date Joined Oct 2006
Total Posts : 41
   Posted 6/18/2007 5:43 PM (GMT -7)   
tkmom,

He lives in Los Angeles area so it's warm most of the year. For some reason he just produces excess synovial fluid.
Should you happen to be moving to the LA area, know a top notch rheumatologist there at USC Medical Center. Recommended to my son by Dr's in NYC @ Mount Sinai Hospital. He's a gem.
Good luck with your move and be sure to get as much rest as possible and don't over do it. I hope your family & friends are rallying around you at this time and helping you as much as possible. It's difficult enough moving but when you're in pain it really sucks!

-Jem

curley
Veteran Member


Date Joined Mar 2005
Total Posts : 4305
   Posted 6/21/2007 10:59 PM (GMT -7)   
I to have this problem as well.I was diagnosed withy crohns and about two months later I started to swell and I mean to the point that I was wheelchair for about a year and I had to under go theraphy to learn how to walk again my mucsels were so weak that we had to streanthin them up again.I can remember that I had 61 pounds of fluid taken off of me.I still swell and it is worse in my lower legs(both)and both ankles as well.right now I can't tell witch is my foot and what is my ankle.I still don't have a doctor that can tell me why I swell like this.

This is what I have medical speaking.
RA
AS
OA
SEJERENS DISEASE
INFLAMATION OF THE NERVE ROOT 'S
Curley
.........
 


The Bear
Regular Member


Date Joined Mar 2007
Total Posts : 364
   Posted 6/21/2007 11:20 PM (GMT -7)   
IS THIS A CASE OF RA CAUSING THE SYNOVITIS OR ARE YOU ALL ON THE SAME MEDICATON? IS IT/CAN IT BE A BY PRODUCT OF THE MEDS? JUST AN OBSERVATION/QUESTION FROM SOMEONE WHO HAS SWELLING FOR THS REASON [UNRELATED].
THE BEAR

tkmom
New Member


Date Joined Jun 2007
Total Posts : 5
   Posted 6/22/2007 5:52 AM (GMT -7)   
I've had this swelling long before I was dx with ra and before I started meds. The prednisone helped with the swelling at first, but it doesn't seem to make a difference anymore.
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