Hip Pain

[rosedial]

Hi All,

I have been a member of this forum for a few years but this is my first post and would appreciated any advice or insight.

I am 53 and have had Crohn's since Jr. HS. I have been on prednisone and numerous different medication through out all the years. I have had 5 operations and also have short bowel syndrome.

I started having hip pain in Dec 2013, had physical therapy and it helped but pain totally never went away and had to adjust my lifestyle to deal with the pain.

Over the last 2 weeks my hip pain is getting worse and I am having a hard time just walking, can't drive and need to basically sit on the couch. I get up to do a few things like wash dishes and prepare food but then I need to get back to the couch because the pain gets worse. I went back to the Orthopedic doctor and had x-rays taken. He said he does not see anything on the x-rays and I probably just pulled a muscle.

My question to anyone who can answer is:

Can you have hip problems caused by Crohn's that you can't see on the basic MRI x-rays? Do hip and sacrum problems take a while before they show up on x-rays or perhaps this type of pain & hip problems do not even show up on x-rays and need to be diagnosed by a very good Crohn's specialist? I live in Trumbull, CT and have been going to local doctors but I am thinking I should make an appointment with a top Crohn's doc at Yale New Haven Hospital.

Thanks for everyone's help and advice in advance.

Rose

 

[CrohnsChicago]

Hi Rose! Arthritis is commonly associated EIM with flares. I too have gotten horrible hip pains (and knee pains) while in a flare as well as while taking steroids.

Given your current symptoms and history of steroids to treat crohn's and age, have you had a bone density test done recently? It's definitely something you should consider.

My GI always recommended that I increase my calcium and potassium while flaring to counter bone loss brought on by steroid use. I also got a bone density test done after my first year on and off steroids since it can be so damaging to your bones.

 

[rosedial]

I would like to make an update. The office lady said nothing showed up on the x-ray but the orthopedic doc just called and he said they CAN SEE arthritis in my left hip and that is the one that is bothering me. He said I need to see him in 2 weeks. He will proceed with what he wants to do after he sees how I am doing in 2 weeks.

I still would love any advice, insight and comments.

Rose

 

[rosedial]

Hi Chicago,

Thanks for replying. I got a bone density test 2 years ago and I had mentioned to the doc perhaps I should get one. They said lets wait and see.

BTW, I have gotten knee pains for years and they slowed me down but they were never as bad as the hip pain that I an now experiencing.

I think you can see in my updated post above the x-rays did show arthritis in the left hip that is bothering me.

Rose

 

[PsychoJane]

There are several pathologies that might be associate either with the Crohn per se or the treatment regimen we are taking. The prednisone amongst them can cause collateral damage such as osteoporosis but also contribute to other conditions that may result in symptoms that involve the hip. X-rays are often not enough to pinpoint early stages of certain conditions and radionucleid bone scintygraphy (different from a bone mineral density scan), CT scan and MRI are more adequate to allow diagnosis.

 

[rosedial]

There are several pathologies that might be associate either with the Crohn per se or the treatment regimen we are taking. The prednisone amongst them can cause collateral damage such as osteoporosis but also contribute to other conditions that may result in symptoms that involve the hip. X-rays are often not enough to pinpoint early stages of certain conditions and radionucleid bone scintygraphy (different from a bone mineral density scan), CT scan and MRI are more adequate to allow diagnosis.

Thanks PJ,

Can you elaborate on what "pathologies" or other problems that you can get. It also looks like you are saying I should get a "radionucleid bone scintygraphy" test to pinpoint what is really going on. The doctor I am going to never mentioned any of these things or this test even after I keep reminding him that I have Crohn's and I have heard that people with Crohn's get problems with their hips and sacrum.

I think I it is time I get a very good doc at Yale New Haven Hospital that understands Crohn's and all the problems I have (such as short bowel syndrome and now the hip problems I am starting to have).

BTW, I would never know that English is not your first language. Your writing is better than most Americans I know.

Thanks, Rose

 

[my little penguin]

Ds sees a Rheumotologist - they handle arthritis associated with Ibd as well as arthralgia .
I would suggest you try to get into a Rheumo quickly .
You can osteoarthritis or Spondylarthrits associated with Ibd .
There would be a big difference n treatment

Article on SpA and gut inflammation
http://www.nature.com/nrrheum/journal/v8/n5/full/nrrheum.2012.42.html

 

[PsychoJane]

Hi Rose,
I apologize for the little delay here. What seemed to be the main concern that my GI had considering my history of pred was that I would have been experiencing osteonecrosis/avascular necrosis. Easiest way to rule this one out is MRI for the early stage, Radionucleid can allow diagnosis but it takes a little longer before it shows up.

By all mean I am not deeply knowledgeable regarding these aspects I am mostly refering to my personal experience and how steps were taken to manage my hip pain situation (which was not AVN finally, it got classified under some spondylarthopaties-sacroiliitis).

As MLP mentionned, it might be interesting if you can get in touch with a rheumatologist. They are really the best to help us with these conditions.

 

[rosedial]

Hi all in this thread,

I spoke with my colo-rectal surgeon who I had been basically using to manage my Crohn's and I bought up some of the things that I saw in this thread. He did agree that I should see a Crohn's specialist and that doc would recommend me to a rheumatologist to look in depth into the problems I am having with my hips and lower back. It never occurred to me that I might need a rheumatologist instead of an Orthopedic doctor until I saw in this thread so I really appreciate everyone's advice.

It is going to take a few months to get an appointment at Yale with the Crohn's specialist but I will let you know how I make out.