NetWellness Arthritis and Rheumatism

Cortisone Shot

Jeffrey Robbins DPM — Sat, 07 Nov 2009 12:11:00 EST

Question: My daughter had a cortisone shot in her foot yesterday for inflamation due to nerve damage between her last two toes. Yesterday she was pain free except for the injection site. Today she is extreme pain, more than before. Should I be concerned?

Answer: This is not uncommon, especially if she walked on it more than she should have because it did feel so good. I would recommend however that you do call the practitioner that gave the injection so that they are aware of this reaction and can make a decision on whether she needs to be seen sooner.

Ask an Expert: Jeffrey Robbins DPM, Arthritis and Rheumatism

RA in Feet?

Jeffrey Robbins DPM — Tue, 27 Oct 2009 19:10:00 EST

Question: I have been dx`d in RA for 6-7 years now, started to have foot pain 3 years ago. I have had surgery and had nodules removed and bone scraped in the 3rd & 4th metatarsals. That has did well, however the pain now in my heal is unbearable, Dr`s tell me ????? and MRI showed fluid. I have been advise . . .

Answer: It is difficult to recommend additional tests other than what you have already had. That said you are always free to get copies of those tests and seek a second opinion on diagnosis and treatment.

Ask an Expert: Jeffrey Robbins DPM, Arthritis and Rheumatism

Rheumatoid Nodules

Raymond Hong MD, MBA, FACR — Thu, 22 Oct 2009 12:10:00 EST

Question: Can rheumatoid nodules in the wrist come and go?

Answer: Rheumatoid nodules on the extremities will not typically come and go. However, synovial cysts can fluctuate in presence or appearance. The synovium is the lining of the joint or tendon. As a result of the inflammation from RA, the proliferated synovium can occasionally turn into a cystic or cyst-lik . . .

Ask an Expert: Raymond Hong MD, MBA, FACR, Arthritis and Rheumatism

Knee Joints Weak

Raymond Hong MD, MBA, FACR — Mon, 19 Oct 2009 12:10:00 EST

Question: Once RA causes knee joint weakness and disability, can it be repaired? Is knee replacement the same thing as strengthing the tendons around the knee? And is having swelling beneath the kneecap with both patellas spurriously elevated, a typical sign of RA, or is it found in other forms of arthritis?

Answer:

Currently, the damage that Rheumatoid Arthritis (RA) causes to the cartilage and bone of a joint cannot be healed. That is why slowing or halting the damage with early and aggressive treatment is important.

Disability and the presence of arthritis do not always go hand-in-hand. Disabilit . . .

Ask an Expert: Raymond Hong MD, MBA, FACR, Arthritis and Rheumatism

RA and Biologics

Raymond Hong MD, MBA, FACR — Mon, 14 Sep 2009 06:09:00 EST

Question: Some of my friends and I have RA, and are on different types of biologics. I have found that well all have been on at least 2 different ones. They either stoped working, didn`t work at all or we had a bad reaction to them. It seem that if they work, they don`t work for a long time, maybe a . . .

Answer:

The medications known as biologics that are currently FDA-approved to treat Rheumatoid Arthritis (RA) are etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), certolizumab pegol (Cimzia), and golimumab (Simponi) [listed in chronologic order of FDA-approval]. A small percentage of peop . . .

Ask an Expert: Raymond Hong MD, MBA, FACR, Arthritis and Rheumatism

Whole Body Aches

Jeffrey Robbins DPM — Fri, 11 Sep 2009 02:09:00 EST

Question: I`ve had plantar faciiatis...cortisone shot, phys. therp., night splint and surgery. During therapy it was discovered that my feet problems were coming from my spine. I have spondylolisthesis. It`s been a few yrs since the surgery and I have bouts of pain in both feet that come and go.&nbs . . .

Answer: The short answer is yes it can. The diagnosis of fibromyalgia is a symptom complex that is not very well understood.

Ask an Expert: Jeffrey Robbins DPM, Arthritis and Rheumatism

Rheumatoid Arthritis and Lupus Together?

Raymond Hong MD, MBA, FACR — Sun, 30 Aug 2009 22:08:00 EST

Question:

Is it possible to have Rheumatoid Arthritis and Lupus at the same time? I have had RA for about 30 years - I was first diagnosed when I was 37. I have always had Rheumatoid nodules along with it. In the last new years I have been told that my bloodwork (over and over) shows that I have Lupus - Ve . . .

Answer:

It is possible to have features of two different rheumatic diseases that overlap on one another. As you have described, you have a long-standing history of Rheumatoid Arthritis (RA) and more recently have developed symptoms that can be found in Systemic Lupus Erythematosus (SLE). Your Rheumatolog . . .

Ask an Expert: Raymond Hong MD, MBA, FACR, Arthritis and Rheumatism

Injectable Methotrexate

Raymond Hong MD, MBA, FACR — Thu, 27 Aug 2009 12:08:00 EST

Question:

I do what my doctor told me to do and so does my friend but when got to different opinions. My doctor told me to inject my methotrexate IM but my friends doctor told her SQ. Could it be done either way?

Answer: Methotrexate may be injected either subcutaneously (SC or SQ) or intramuscularly (IM).

Ask an Expert: Raymond Hong MD, MBA, FACR, Arthritis and Rheumatism

Interpreting Elevated ANA and ESR Results

Raymond Hong MD, MBA, FACR — Tue, 11 Aug 2009 14:08:00 EST

Question: Recently, I received bloodwork results indicating a high ESR of 54 and an ANA of 1:160 speckled. My doctor believes these markers could be a result of gallbladder surgery performed in May of this year. I`m curious to know if a surgical procedure could cause these elevated levels.

Also of note, . . .

Answer: ESR and ANA elevations may be reactive to a multitude of causes. However, if your symptoms persist at a time even further out from your surgery, then it would be reasonable to repeat the laboratories.

Ask an Expert: Raymond Hong MD, MBA, FACR, Arthritis and Rheumatism

Elevated ESR and Speckled ANA Results

Raymond Hong MD, MBA, FACR — Mon, 10 Aug 2009 17:08:00 EST

Question: Recently, I had a battery of blood tests (normal CBC) which included a slightly elevated ESR and a slightly elevated, speckled ANA. My doctor says this is suggestive of an auto-immune disorder, but could likely be the result of having my gallbladder removed in May of this year. I would be interested . . .

Answer: Thank you for visiting NetWellness. On this site, we try to answer general questions about health but cannot diagnose or recommend treatment. You appear to have some very, very specific questions about your condition, which can only be answered properly by a physician who is familiar with . . .

Ask an Expert: Raymond Hong MD, MBA, FACR, Arthritis and Rheumatism