My Rheum Visit today...arthralgia?

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Regular Member

Date Joined Apr 2007
Total Posts : 22
   Posted 2/9/2009 10:27 PM (GMT -6)   
Hi!! It's Nicole. It's been awhile since I have written. I have been overwhelmed with school and work. I last wrote after my last PCP visit in January.

Well...I had my f/u rheum appt today and he diagnosed me with arthralgia. Anyone ever heard of it or been diagnosed with it? He also gave me the perpetual "I don't know what's wrong. We know very little about this area of medicine" speech. At least he was honest.

I still have an elevated ANA and SSA titer. I have been feeling better lately. I have really been focusing on resting, exercising and not stressing which I know is helping.

I feel relieved but at the same time I am tired of going through this cycle over and over again. It's been six years of this. I guess the good thing is that there are lab results that support my complaints.

Regular Member

Date Joined Nov 2008
Total Posts : 106
   Posted 2/10/2009 2:35 AM (GMT -6)   
Hi Nicole, yes i have heard this myself almost verbatim. At first they thought it was RA then arthralgia then later MCTD with Sjogren's now just MCTD maybe??? As my Rheumy put it "it's a DX in progress". They know you have something, but it just doesn't fit nicely in the little boxes they have for each disease. I agree it's great to have the test results to prove not only to others that something is actually wrong, but to yourself. I know i questioned myself until i had the results. Here's hoping you get the final DX that gets you on the right track. Hang in there and i hope you have more good days than bad.

DX: IBS 00, +ANA 05, Depression 06, MCTD & Sjogren's 07, GER 08, NO Sjogren's 09, ?????  
Meds: Plaquenil 400mg, Prednisone 10mg, Celebrex 200mg, Effexor 150mg, Nexium 40mg and Amitriptyline 10mg
Life is what you make of it.  Just something I try to remind myself every day.

Regular Member

Date Joined Oct 2005
Total Posts : 130
   Posted 2/10/2009 4:45 AM (GMT -6)   
Hi Nicole

The flaw in this is that arthralgia is not a diagnosis but a symptom. It only means joint pain and it's the cause of the joint pain that will be the diagnosis. There are many possible causes of joint pain - injury, infection, autoimmune connective tissue diseases, other autoimmune diseases, even drug induced
We tend to think that the word inflammatory means there is something visible. If there are visible signs of joint pain (and maybe obvious damage) such as swelling, redness, heat and mis shapen it would be called chronic arthritis unless this is due to injury which can be treated. The " - itis" ending means inflammation, the "-algia" ending means pain, as in neuralgia or fibromyalgia.

In lupus as opposed to RA, joint pains commonly are technically arthralgia and not arthritis with visible signs. Also deformity is not very common in lupus, either visibly or internal damage to joints.
Lupus is described as an inflammatory disease because inflammation results from any special activity of the immune system from whatever cause. I have often heard of doctors saying it can't be lupus because your joints look OK. That is rubbish.

Oddly enough the blood signs of inflammatory processes are not always elevated in lupus, but of course elevated SED and CRP levels help greatly to diagnosis. High CRP levels though might indicate an infectious cause rather than lupus

Joint aches and pains are one of the most common symptoms of lupus and for some people the main symptom. However there would have to be other signs and symptoms before the aches could be attributed to lupus as opposed to anything else.
Look carefully over the ACR Criteria for Lupus and compare it with your symptoms or any blood test abnormalities. Make sure all the usual tests have in fact been done.

I am pretty sure that the presence of anti- Ro antibodies is abnormal whatever the titre. The higher the ANA titre the more likely it is due to Lupus. 1:320 and above is considered more likely than the lower titres which might be due to other illnesses or none at all.
Sometimes lupus can only be a diagnosis of exclusion.

I would be looking for another doctor because if it is chronic arthralgia the cause should be found so that correct disease modifying treatment can be used not relying entirely on anti inflammatories or steroids for relief.

All the best

Post Edited (BumbleBee1) : 2/10/2009 9:33:00 AM (GMT-7)

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