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Seven years of pain - my rheumatologist is stumped. Desperate for help.
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keuphrat posted:
Symptoms:Beginning in 2005, I have had recurring episodes of painful swelling in one or both knees. These flare-ups typically happen once every three to six months, but have recently been happening every month. The flare-up starts as a dull stiffness, and usually within three or four days, the knee has swollen to twice its size and has become extremely painful to put any weight on. The worst pain/swelling usually lasts for four to six days. Then the knee begins to slowly decrease to its normal size, but it takes three to four weeks before all pain is gone.
Between flare-ups, I have no symptoms. In fact, I'm very active and even run half-marathons. My running has never brought on a flare-up - in fact it seems to keep them at bay. It often feels like nothing at all has brought on a flare-up (for example, my current one happened after I hadn't even gone on a run in a month). But I have also had flare-ups that appear to be the direct consequence of bending my knees too much - for example after a 26-mile bike ride on a bike that was too small for me (causing my knee to bend at a sharper angle than is natural). The pain is not worse or better depending on the time of day or the weather.
The swelling can get so severe (the knee becomes the size of a cantaloupe) that the slightest touch to the knee is extremely painful - for these especially bad episodes, I use crutches to get around.
In the past six months, I have had six flare-ups. Normally I experience 2 to 3 flare-ups per year. When these flare-ups started in 2005, they would alternate between my left and right knees. Then for five years,only my left knee flared up. Now, for the first time in five years, my right knee has flared up again - and this time, both knees are swollen and I can barely walk or stand.

Treatment and Diagnosis History:I first saw a knee specialist at the Illinois Bone and Joint Institute who thought I may have the beginnings of osteoarthristis based on an MRI of my left knee. My next doctor, in Las Vegas, gave me injections of Euflexxa and I then went without a flare up for a full year. My orthopedist in San Diego did not agree with the osteoarthritis diagnosis after looking at an x-ray and MRI of my knee both when it's healthy and when it's swollen. He does not think it is mechanical but rather a malfunction of my immune system. He sent me to a rheumatologist, who has given me a "working diagnosis" of Palindromic Rheumatism . He has extracted the fluid from my swollen knee twice. The first time, the fluid was bloody and when tested in the lab it showed gout crystals. The second time, the fluid was not bloody and showed no gout crystals but did show "inflammatory properties." Last year, I started taking 0.6mg of Colchicine twice daily, and at first I didn't have a flare-up for several months but now I get them more often than ever. In addition to the colchicine, which I am still taking, I began taking 300mg of Hydroxychloroquine once daily on January 11, 2013.
I am eating an anti-inflammatory diet, reducing my intake of sugar, grains, and Omega-6 fatty acids, while increasing my vegetable and Omega-3 fatty acid intake.
Potentially Related Family Medical History:My maternal grandmother had rheumatoid arthritis late in her life. My mother was just diagnosed with osteoarthritis in her knee. My father and his brother and nephew all suffer from Psoriasis, but it has not developed into Psoriatic Arthritis in their cases - although Psoriatic Arthritis is one possible diagnosis my rheumatologist has mentioned for me because of this family history.
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LadyNerilka responded:
Maybe for you arthritis look into a TNF inhibitor. They have come a long way in the last few years.


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