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Peripheral Arthritis

Hi All,

My wife (Age 25) is suffering from Ankylosing Spondylytis. Though she was all fine till last month. Then she has a minor accident where she injured her right knee. Since then it has swollen and she can not walk.

Doctors said that she has Peripheral Arthritis as well. They gave her one Steroid injection and started her on sulfasalazine  (1gm per day). Her pain has gone, but she still can not walk. She feel weak and stiffness while walking.

It is 6 weeks since her accident and 2 week since her medication started. I am concerned that will she ever be able to walk? What all she need to do to get well ASAP. Please guide.

She is of Indian ethnicity and she is in London.

Thanks.

10 Responses
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469901 tn?1276563623
Hello.  I have ankylosing spondylitis too.  The auto accident may have caused her to flare and she may have something else going on.  Is she unable to walk because of back pain?  I am guessing the steroid injection was in her knee.  Did anyone look at her back?  If she is not being treated by a rheumatologist for her AS, she needs to get to one and to be placed on a treatment plan.  
If this is related to a flare of AS, she may take some time to get better but with treatment she should be able to get her symptoms under control and be able to walk again.   The amount of time it will take is not predictable, it could be rapid or it could be a lengthy recovery.  Her doctor will be better able to advise.
Helpful - 0
Avatar universal
Hi,

Thanks for your reply. It is nice to hear that she will be able to walk again.


She is being treated by a rheumatologist in London. He has started her on sulfasalazine
tablets (started 2 weeks ago only).
No, her back is not paining. It is fine. The doctor checked her back as well. The steriod was give in her knee.

I hope and wish that she starts walking soon.

Thanks.
Helpful - 0
469901 tn?1276563623
I am glad her AS is being treated.  I hope she responds to the sulfasalazine but there are other treatment options available if she does not.  Sometimes it takes awhile to get the dosages correct.  
If her knee is not getting better it may be time to get in touch with the doctor again....
Helpful - 0
Avatar universal
Hi,

Its 3rd week now and she has started taking 3 tablets of sulfasalzine now. She will increase it to 4 next week.

She is still not able to walk. Yesterday sh tried walking and her leg got swollen. It does not pain though. She is feeling very week in her right leg. She can not lift it on her own.

We will go to see the doctor on 15th. He is a very busy doctor. Very difficult to catch him.

Helpful - 0
469901 tn?1276563623
I am glad you are getting her back to the doctor but am concerned that it will not be until the 15th.  The sulfasalzine will help her AS, but I am not aware of how it would benefit her knee.  I suggest you ask for additional tests on her knee and leg.  Is there any way you can get her in to see someone sooner?  Do they understand that she is not getting better and cannot walk?
Helpful - 0
Avatar universal
Hi,

The doctor advised Physiotherapy. She started that. Her leg was getting better and stronger. She was able to lift it up on her own, but she was feeling some pain as well while lifting.

Then she got some courage and started walking on her own. She went to the nearby shopping center for two days. Then her knee swelled again. She is getting the swelling in her ankles as well.

We are upset that as soon as she started walking, the swelling came back. And above all, she is still on her crutches.

She is taking 2gm of sulfsalazine daily and she also takes 3 tablets of diclofenac (NSAID) daily.

If she misses any NSAID then her whole body starts paining.

I wonder what to do now.

All the doctors are saying that she will be fine as the blood test are not giving any bad result.

I am scared that taking so many NSAID may damage her other body part as well.
Helpful - 0
469901 tn?1276563623
Is there any way you can get her to another doctor?  I agree that it is a concern that she is not improving.  I am also concerned that they are relying on the blood work so much.  There are other tests that could and should be run like a bone and joint scan.  I would ask the doctor if it could it be that the sulfasalzine is not sufficient to help her and a stronger medication needs to be tried.  I will keep you both in my prayers.
Helpful - 0
Avatar universal
Thanks a lot for your kind words. She will see a new doctor on monday.
I must say, getting appointments in UK is one hell of a job. NHS (national health service) is so bad here.

Anyways, we are hoping that the new doctor might do some more tests on her and give some proper medication as well.

I cannot believe that she is not able to do anything on her own now a days. She was all fine 3 months back. Running and jumping... She even went to Switzerland with me in april this year. She did some snow jumping and sledging there, and suddenly a small mistake of walking very fast on a paining knee caused so much of trouble.Simply not believable.

I can see her going in depression. It is getting very hard to keep her motivated.
Helpful - 0
469901 tn?1276563623
I am glad you are getting in to another doctor!  I hope this one will work out better.  I am certain she is getting depressed.  It is hard to be in pain and debilitated and not get depressed.  Pain makes everything harder and even changes our personalities.  I am certain most things that we do and take for granted feel like a chore to her.  You are a very supportive husband to her and that is what she needs.  Your active role in seeking a successful treatment plan is making a huge difference.  Keep up the good work and give your wife a gentle hug for me.  There is hope.  It took 3 years for me, but I am finally getting better so I believe she will too.
Helpful - 0
Avatar universal
Hi,

We saw the new doctor today.

He analysed her. He changed her NSAID from diclofenac to Naproxen.
She is still anaemic (9.2) and her ESR is still high (140).
He said Sulfasalazine generally takes 3 months to act hence we will have to wait for another 1 month.

Then he also suggested her to take Steroid shots in her knee and elbow.
She is not at all willing to take that as she is afraid that her body might get used to this and will be life long dependant on it. She is also afrad about the side effects.

He also asked to get the physiotherapy started in full swing.

Overall nothing very new. The dignosis is same : AS with Perpherial Arthritis.

Do you think that it is right to say NO to Steroids? OR is she making big mistake in saying NO?

Please advice...

On internet I get to read so much about the Pros and cons that I am badly confused.

Thanks.
Helpful - 0
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