New/additional diagnosis- what does it mean?

[tots]

Last week I saw a new Rheumatologist, she went over my medical history, looked at my joints. Asked why if I am still having symptoms with my CD did my GI not add another medication!?! After looking at my joints and symptoms she put me on Methotrexate.

Yesterday I got a call from her office, X-rays of the hands show erosive osteoarthritis. When I looked it up its Inflammatory Erosive Arthritis. If I understood correctly it is associated with autoimmune diseases. So the big
question is..... is this a CD related issue.

From what I understand you can have the arthritis long before they see the damage, that fits my symptoms. Than it also makes sense the other joints
I have there symptoms in to follow as far as being able to see the damage ??

Thank you in advance for any help in this area!


Lauren

 

[Clash]

Here's an article on the extra intestinal manifestations of CD, it includes some involved with joints

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127025/

 

[Maya142]

Typically, osteoarthritis is not an EIM of Crohn's disease. Generally, the arthritis associated with IBD is Spondyloarthritis. Has SpA been ruled out for you?

Erosive osteoarthritis is a bit different. Some researchers do think it's inflammatory and others think it could be autoimmune. However, it is usually treated with the same medications that are used for regular osteoarthritis:

IEO vs. Rheumatoid Arthritis
IEO is similar to rheumatoid arthritis in that the inflammatory process is taking place in the body, and over time, there is damage to the joint, which can be seen as erosion on an x-ray, he says. However, unlike RA, eventually the inflammation will subside.

“It may leave the patient with an enlarged joint,” he says, but the progression of damage is halted. This is why early aggressive treatment of IEO is not necessary, even though that is key to stopping joint damage with RA.

Even so, Dr. Zashin says IEO can be hard to distinguish and is not that common. It takes a combination of x-rays, lab work, location of arthritis and symptoms to help determine the diagnosis.

IEO vs. Osteoarthritis
Though IEO is considered a subset of osteoarthritis, there are major differences. “There is more inflammation with the joint and there is a more rapid progression,” says Dr. Zashin. X-rays changes also look different in IEO compared to OA, because there is some erosion in the bone.

Where these two conditions meet is in the treatment, according to Dr. Zashin.
“We treat erosive osteoarthritis the same way we treat osteoarthritis,” he says. “We treat the symptoms.”

That includes both over-the-counter medications, such as Tylenol and topical anti-inflammatories, as well as prescription medications approved for osteoarthritis. Joint injections are another option, says Dr. Zashin, “ and in resistant cases we use similar treatment to rheumatoid arthritis, such as Plaquenil, or a drug for gout called Colchicine.”

 

[tots]

The article I read listed Methotrexate as a way of treatment
also Prednisone, that's where my confusion kicked in.


Lauren