Arthritis Community
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1378884 tn?1315509445

Osteoarthritis vs RA

I am just curious as to how Docs figure out which type of arthritis one has. I am also a hashimotos survivor and am concerned that it may be having an impact on my knees which have done things over the years that no one of my size should have done. It's mostly confined to my left knee. I have broken both knee caps in the past, (car accident and Karate Class) had a meniscus tear repaired, which made left knee much worse.

Hands and feet are fine. Usually wake up fine ( as fine as a 55 year old can be) and by the end of day or frequent use (walking/weight lifting) I am in extreme pain and no flexibility.

My Doc had me try some Celebrex which took the edge off the pain and allowed me to be more active but I was far from pain free.  Going in for an MRI. Will that tell me which type of arthritis I have or if I have both and what exactly are they looking for?
5 Responses
1193998 tn?1265121197
In a nutshell, osteoarthritis is wear-and-tear on the joint. It can happen at any age, not just to "old people". It can be brought on by an injury, a congenital deformity, overuse in a sport or job.

RA is a malfunction of the immune system in which it mistakes joint tissue, mainly the cartilage, as something that must be attacked and eliminated. This causes the typical swelling, redness, heat, and over time, damage that causes pain and disability. Cartilage is eaten away; even connective tissue such as tendons and ligaments can be affected as well.

The confusion often arises because RA damage *can* lead to OA in the joints; however, OA does NOT cause RA. Make sense? :)

Hashimoto's is related to RA in that it's an autoimmune disease. In fact, many autoimmune diseases occur together; in my experience in talking with other patients, AI diseases rarely occur by themselves. I know many patients with multiple diagnoses - RA with lupus, RA with fibromyalgia, RA with Hashimoto's and other disorders like Sjogren's, Still's, Felty's...the list goes on.

I hope this helps!
1378884 tn?1315509445
Yes you helped!

I also have a workplace injury, fell on sacrum and R hip last November. I am starting a course of prednisone for 30 days. Never had problems with hip, (pain is radiating to my foot) or back until I fell. Is the Doc trying to rule out RA or Osteo for my R hip?  I understand that prednisone is a inflammation reducer and autoimmune suppressor. He found a deposit on the bone near hip as well. MRI tomorrow too.

So if my hip feels better,  pain goes away in foot then it may be that I have RA and Osteo which is exacerbated by the mechanical injury or visa versa.

What do ya think, anyone?

1193998 tn?1265121197
Prednisone can make you feel better whether you have RA or OA. It's a general purpose inflammation reducer used in a wide variety of diseases. It can be injected directly into a joint to ease pain and swelling, given in an intramuscular injection or taken orally to quiet an overall RA flare-up, inhaled to help asthma and COPD patients breathe better, and more. My mom takes injections in her lower back to temporarily ease pain. My guess is you have a low back injury that is irritating the sciatic nerve, which travels down the back of your hip and down your leg. Bone deposits can build up due to altered mechanics in how your walk, sit, stand, etc. after an injury. The old song, "the hip bone's connected to the knee bone" has more than a little truth to it!  A foot injury, for example, makes you limp. This puts stress on the adjacent joints, so eventually your knees, hips and back start to hurt, too. This is why the goal of physical and occupational therapy is to get you back to normal, even function - to prevent further problems down the road.

When I had my first hip replacement, it made my leg a good 1-1/2 inches longer than the other one. Over the three years before I had the other hip replaced, I developed problems in my left foot, opposite knee, and lower back.

Having said that, RA can have many different triggers. A common infection can trigger the immune system to start attacking the body  - no one knows why. Stress or an injury, basically anything that prompts an immune system response can potentially trigger RA or another autoimmune disease. It can run in families, or appear apparently out of nowhere. My guess is you do NOT have RA and likely won't develop it, but your doctor may be testing you just to be safe.

Look up the  common initial symptoms of RA on a site such as here on medhelp.org or arthritis.org. I think you'll find it eases your mind...or it may spark a conversation with your doctor that can lead to early treatment!

It's important not to rely on prednisone for the long-term - the long term side effects are not pretty. IMO only it's better to sumbit to surgery to fix the problem as well as it can be fixed, but that's a personal decision. :)
1378884 tn?1315509445
AWESOME answer!. It's what I thought he was doing, ruling out RA. I don't seem to have the typical RA symptoms (which is reassuring) either. I have had to adjust my movement because of the R hip and now am having issues with my Left Knee. Crazy!. Anyway your help will provide me with conversation material with my Doc in a couple weeks. The Prednisone is really not helping the hip or back pain pain as of yet but it's early. Is celebrez ok for inflammation relief with fewer side affects?

Thanks Again.
1193998 tn?1265121197
Celebrex is an excellent anti-inflammatory for a lot of people. It can have some potential cardiac side effects in some people (which is why it was pulled of the market for a short time a few years ago), but just keep an eye on your blood pressure. Use a home cuff but don't go overboard checking your BP 5 times a day! Check it about once a week. I like to do mine first thing in the morning before I get out of bed. BP tends to rise over the course of the day, so doing it first thing gives you a good baseline.

It can wreak havoc on your stomach, too, so never take it on an empty stomach or right before bed, when you're going to be horizontal. Tell your dentist you're on it, too, as you might experience some gum bleeding at your next cleaning.

You might think about using a cane or crutches temporarily to support your hurting joint and take stress off your healthy joints. I know, I know, no one likes to use those things, but it'll help keep the rest of your body aligned. Maybe just use it if you know you're going to be walking more than normal.

Prednisone generally works VERY quickly, so if you aren't noticing a big difference after a few days, it likely isn't going to help in this instance. My Mom generally gets very little or very short term (a few days) of relief from an injection. They give her a mixture of Kenalog (liquid prednisone) and lidocaine, a numbing agent. It seems like as soon as the lidocaine wears off, the pain is back.

Keep us posted as to how you're doing! Good luck!!
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