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Answers: Page 1 of 13
Shikha from Edmonton asks: Can a Rheumatologist diagnose whether the symptoms experienced are Chronic Fatigue Syndrome, Auto Immune and or Fibromyalgia?
Yes, this is exactly what rheumatologists do. We listen to your symptoms, to an exam and review any available investigations. Based on this, we can usually determine what is happening and differentiate between these diagnoses.
Linda from Alberta asks: I have been diagnosed with RA and find my joints are making noises like cracking a knuckle. Is this normal or common?
Regardless of the reasons, noises coming from joints are usually not a concern, unless they are also associated with pain. If you are having pain, you can discuss this with your rheumatology team to see if there is something more than needs to be investigated or treated.
Diana from Edmonton asks: What if your appt is 6 months away to be seen by a rheumatologist and neither you or your doctor think you are going to make it that long?
Wait times for rheumatology appointments in Alberta have grown much longer over the last few years. This is never ideal for folks who have joint pain, stiffness or swelling, or symptoms as a result of 100s of different rheumatic diseases. We need over a dozen more rheumatologists in Alberta and/or a new model of care. If your doctor thinks you need care sooner, they can always contact the rheumatologist on call to discuss what is happening and get some advice on what to do in the meantime. Sometimes, this also can result is a sooner appointment. If you are interested to learn more about rheumatology advocacy in Alberta, visit our webpage here to join our patient advisory council.
Unfortunately, there is probably not one best natural supplement for arthritis. There is still limited data to help tell us if a particular natural supplement may help arthritis, which type of arthritis, and what risks there are. That said, we have compiled a list of supplements our patients commonly use with the available research and risks as they exist today. Hopefully this helps.
ESR (erythrocyte sedimentation rate) and more recently, CRP (C-reactive protein), are tests that can detect inflammation in the body. They are not perfect tests. It is possible to have normal results and have active inflammation. It is also possible to have active inflammation which is not related to inflammatory arthritis. For example, an infection will cause these tests to be elevated. These tests typically do not make a diagnosis of inflammatory arthritis on their own, but can help put a picture together of a diagnosis. They can also be used to help monitor how the arthritis is doing, but again, it must be used with other information as well. A normal or elevated test on its own does not mean arthritis is active or not.
Paul from Calgary asks: I have Gout. I take allopurinol and indomethacin; I also take ibuprofen when I have exceeded my daily indomethacin intake. I experience Gout attacks daily. Is there something I can take that would work better?
A few things to consider for gout. 1) It is best not to mix different anti-inflammatories (NSAIDs) at the same time. Once you have maxed your dose on one anti-inflammatory, you are maxed on all of them. It is not a time to switch to another one. 2) If gout is not controlled on allopurinol, it probably means the dose of allopurinol is not right and needs to be adjusted. Watch our recent video for more on this exact topic. 3) If your gout is not controlled on allopurinol and you are having daily attacks, it is possible this is not gout. Reviewing your symptoms with your doctor or rheumatology team may be worthwhile to ensure you are on the right treatment for the right diagnosis.
Assuming no other medical problems, there is no concern using acetaminophen when you are also taking methotrexate. As long as you are not taking more than the maximum dose, and doing the bloodwork monitoring suggested by your rheumatologist, there is little risk to take both. However, if you need acetaminophen, you should discuss this with your rheumatology team to ensure your pain is not a result of active inflammation, in which case, there may be other medication options which are more appropriate for the situation.
Susan from Calgary asks: I have osteoporosis, with bone density loss in my hip and my spine. How can I rebuild bones without taking a bisphosphonate – I had to stop due to serious side effects after 8 weeks.
Fortunately, there are many different options for osteoporosis treatment today. Taking appropriate doses of Calcium and Vitamin D, as well as weight bearing exercises, are key. For more on osteoporosis, we have information on our webpage here, with the most up to date options on medication treatments listed on a sister site at naop.ca (Northern Alberta Osteoporosis Program).
Jeanette from Edmonton asks: I recently saw a rheumatologist who says I don’t have inflammatory arthritis because there is no swelling on exam. Is that truly the case?
In most situations, a rheumatologist can detect swelling in the joints on a physical exam, assuming there is swelling, which helps make a diagnosis of inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis, etc.) However, it is never that simple. Equally important is listening to how you describe your joint pain, stiffness and swelling; and there are situations where the history, in the absence of swelling, leads the rheumatologist to do more testing (for example, ultrasound). In most cases, when a rheumatologist says someone does not have inflammatory arthritis, it is because the symptoms do not quite fit AND there is no swelling on exam.
Jody from Edmonton asks: I am worried I have symptoms suggestive of rheumatoid arthritis but all the tests come back negative. What should I do?
Diagnosing rheumatoid arthritis is a clinical diagnosis. While there are blood tests and imaging (including x-rays, ultrasound or MRI) which can be helpful to make the diagnosis, it is possible to make a diagnosis even when all these tests come back normal/negative. Your story and physical exam are critical and should not be ignored. Having a referral to the rheumatology team to listen to your story and determine a diagnosis is a great next step.