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Osteomyelitis? Avascular Necrosis? HELP!!!
by Lauri8967, Aug 22, 2008 10:42AM
Hi
I was wondering if anyone had any ideas about what is going on with me...I am a 41 yr old female with SLE (lupus). I am currenly in a flare, and my doc has me on a double dose of prednisone. I have been on 20mg. for over 2 months, and now am tapering down from 40 mg. THis past week, I have not felt well (night sweats, fatigue, just lousy). In addition, after being on my feet for a while (particularly bending over at hip), I get an AWFUL pain through my hip, around my back and down my legs. My legs feel as if there is no blood getting to them - so the pain is intense and tingling-like. It takes me getting off of my feet for a while for the pain to go away. Two days ago, in addition to that pain, a new pain started that came from the hip, across the front and down my thigh to my knee, down my shin to my heel. This pain is not like the other pain, but severe BONE PAIN...I have a high tolerance for pain, and am on all kinds of anti-inflammatories, and steroids, and this pain is AWFUL...
Does this sound like osteomyelitis to anyone? Or maybe avascular necrosis due to the steroids? I would really welcome ANY ideas and suggestions. I have a call into my doc right now, as a friend of mine who is a nurse, said I should be seen right away. Do you agree?
Thanks for any info -
lauri
I was wondering if anyone had any ideas about what is going on with me...I am a 41 yr old female with SLE (lupus). I am currenly in a flare, and my doc has me on a double dose of prednisone. I have been on 20mg. for over 2 months, and now am tapering down from 40 mg. THis past week, I have not felt well (night sweats, fatigue, just lousy). In addition, after being on my feet for a while (particularly bending over at hip), I get an AWFUL pain through my hip, around my back and down my legs. My legs feel as if there is no blood getting to them - so the pain is intense and tingling-like. It takes me getting off of my feet for a while for the pain to go away. Two days ago, in addition to that pain, a new pain started that came from the hip, across the front and down my thigh to my knee, down my shin to my heel. This pain is not like the other pain, but severe BONE PAIN...I have a high tolerance for pain, and am on all kinds of anti-inflammatories, and steroids, and this pain is AWFUL...
Does this sound like osteomyelitis to anyone? Or maybe avascular necrosis due to the steroids? I would really welcome ANY ideas and suggestions. I have a call into my doc right now, as a friend of mine who is a nurse, said I should be seen right away. Do you agree?
Thanks for any info -
lauri
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The course of corticosteroid is not so long enough to cause avascular necrosis of the hip. However, there might be still a rare possibility that the initial symptoms might be the same. Moreover, the symptoms have to be related very well the disease per se.
The following information would help.
Avascular necrosis (AVN) is defined as cellular death of bone components due to interruption of the blood supply; the bone structures then collapse, resulting in bone destruction, pain, and loss of joint function. Early diagnosis and appropriate intervention can delay the need for joint replacement. However, most patients present late in the disease course. Without treatment, the process is almost always progressive, leading to joint destruction within 5 years. Patients taking corticosteroids and organ transplant recipients are particularly at risk of developing AVN. It may be asymptomatic and is occasionally discovered following radiography. Symptoms depend on the affected joint.
Pain in the affected joint is typically the presenting symptom, regardless of the location. Patients with the involvement of the femoral head often report groin pain that is exacerbated by weight bearing. Is the pain more on bearing weight?
The pain may initially be mild but progressively worsens over time and with use. Eventually, the pain is present at rest and may be present at night
Refer: http://www.emedicine.com/Med/topic2924.htm
Best.
Take care