Nanners and others with Crohn's arthritis

my doctor calls my joint pain inflammatory arthropathy. Prednisone helps my joint pain alot but nothing else has except if I take percocet. I am hoping that I will get my humira approved soon (being appealed because insurance company denied it) because I heard it works good for the pain.

If you're not seeing a rheumatologist you might ask for a referral for evaluation of your arthritis symptoms and treatment plan.

lovemyboys - I'd talk to your doc right away about going on sulfasalazine. There shouldn't be any problem getting insurance approval for that and it might help a lot.

Post Edited (rlsnights) : 12/22/2010 11:38:14 AM (GMT-7)

Nope mine is good ol Osteoarthritis. I just turned 53 and I guess as you get older this is quite common and then throw in years of off and on steroid use and the damage is done.

I wouldn't normally do this but the IBD Working Group website is rather arcane and hard to use. Finding articles can be a chore and you can't link directly to the articles.

So here is a summation of the article written by Arthur Kavanaugh, MD
Professor of Medicine, Center for Innovative Therapy
Division of Rheumatology, Allergy and Immunology
University of California San Diego, San Diego, CA

Peripheral arthritis in patients with IBD-associated arthritis is typically inflammatory, asymmetric and affects fewer than 4 joints. The larger joints (i.e., knees, ankles, elbows) are most likely to be affected.

This type of presentation is unusual for rheumatoid arthritis, which commonly involves the small joints of the hands and feet.

There are 2 types of peripheral arthritis in IBD. Type I is the classic arthritis that affects the large joints.Type II is much less common and presents more like a seronegative small joint arthritis.

Clinical presentation/classification:

Type 1 = an acute, self-limiting arthropathy that affects less than 5 joints. It lasts an average of 5 weeks. It normally includes a large joint and is associated with relapses of IBD and both erythema nodosum and uveitis

Type 2 = A symmetrical seronegative arthritis affecting multiple joints. Symptoms don't match IBD flares. There tend to be persistent symptoms that last an average of 3 years. Type 2 is associated with uveitis but not erythema nodosum.

*Neither form is seropositive, erosive, or deforming.* This means you cannot detect this kind of arthritis with blood tests like you can identify rheumatoid arthritis.

"Important other manifestations of IBD arthritis and other diseases categorized as spondyloarthropathies include enthesitis and dactylitis. Entheses are areas where tendons, ligaments and joint capsules insert into bone; inflammation of these areas is common in these types of arthritis and can be the cause of significant symptoms. Dactylitis refers to swelling of an entire digit, and results from arthritis of the joints of the digit in addition to abundant extra-articular inflammation.

Therapy of IBD arthritis is similar to that of other spondyloarthropathies."

NSAIDs are the main treatment for this type of arthritis. But IBD patients should not take NSAIDs. Steroids are usually used for short term control of symptoms.

"The most commonly used disease modifying drugs include sulfasalazine and methotrexate. Of note, TNF inhibitors have been shown to be very highly effective for many manifestations of disease in patients with spondyloarthropathies."

As I said before, I would suggest you consult a rheumatologist and let the two specialists duke it out over the correct diagnosis and treatment.

Frankly, not to put your GI down, but GI's are trained to treat inflamed guts. Not inflamed joints. I myself would probably want to consult a rheumy if only because they are the experts in inflamed joints you know? Especially if I were facing going on morphine sulfate to treat chronic pain.

As I said before, it could also be fibromyalgia. Getting an accurate diagnosis is important so you can get the best treatment - hopefully one that would reduce your pain to the point you don't need pain medication on a daily basis.

Just my 2 cents.

My husband had some crazy arthritis last year. He woke up with his SI joint inflamed, and then his neck went completely stiff, and right knee started blowing up like a baloon (water on the knee). He had to get fluid drained from the knee almost every day, and had 2 cortisone shots in his knee, was put on 40 mgs of prednisone, and they upped the frequency of his remicade from every 8 to every 6 weeks. My husband had just recovered from a bout of c-diff (but no crohn's flare up), and had recently gotten a flu shot.

I don't think it fits either type mentioned in this article. The rheumatologist called it a sero-negative spondyloarthropathy (meaning it doesn't show up in blood work). She also said that unlike rheumatoid arthritis, this type of arthritis does not cause deformity. She said it was either Crohn's arthritis or reactive arthritis (to either c-diff or the flu shot). So, they recommended that this year, he avoids getting the flu shot (though she felt reactive arthritis was more possible because of c-diff), but wanted to be safe.

PV

Well, methotrexate and remicade help , But , I'm holding out for a full body transplant .

Nanners -

Didn't mean to offend - please accept my apologies if I did so.

I meant my comments and the article as a response to heatmiser and lovemyboys09 who had responded to the thread.

Sorry that wasn't clearer. I will try make sure I do a better job identifying who I am replying to in the future.

Best wishes for a happy holiday.

Patricia

another one in need of a whole body replacement...but I need the Cote de Pablo model
(she plays Ziva David on NCIS)...www.imdb.com/name/nm1580243/

BTW, the arthritis really bites...I mean crohn's is bad enough...seriously, I mean I must have been bad, bad, bad, cuz if it's karma then I must have been horrid!