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Answers: Page 8 of 8

Betty-Lou from Edmonton asks: I have bursitis of my hip. What should I do?

Trochanteric bursitis is an inflammation of the bursa on the lateral (outside) aspect of the hip. It can hurt more with walking or lying on the affected side. Treatment options may include physiotherapy (see our Regional MSK Disorders page for some basic ones to start), anti-inflammatory if appropriate, and sometimes a cortisone injection into the bursa.


Tiger from Alberta asks: Is an MRI ever used to help diagnose rheumatic disease?

MRI is a sophisticated imaging technology which can look at bone and soft tissue in the body. In rheumatology, an MRI is most often used to help detect signs of inflammation. However, this is not commonly done as inflammation can usually be detected on physical examination with your rheumatologist.


Carmen from Edmonton asks: Can I safely take Tylenol for pain while receiving Methotrexate injections?

Over the counter pain relievers such as acetominophen (Tylenol), ibuprofen (Advil, Motrin) and naproxen (Aleve) are all generally safe to take with methotrexate.


Chris from Sherwood Park asks: I am taking methotrexate injections. folic acid and Humira for my RA. I seem to be getting many more canker sores lately. Is there anything else I can do besides taking the folic acid to prevent them?

Mouth sores can be a side effect from methotrexate and one you should discuss with your rheumatologist to determine the best way at treating them. Options include increasing the dose of folic acid, decreasing the methotrexate, or replacing folic acid with folinic acid. The choice is unique to each patient’s situation and should be discussed with your doctor.


Michelle from Sunny Island Beach asks: I have RA and Lupus and have been taking Methotrexate and Plaquenil in combination with rituximab. My insurance will no longer cover Rituxan but it will cover Humira or Enbrel. Is it possible to replace rituximab with a TNF blocker? My doctor told me I can’t “step down” from rituximab to another medication.

For rheumatoid arthritis, there is no clear evidence to suggest any biologic when used under optimal conditions is better than another. A patient would never be stepping down between different biologics, just switching. However, patients with lupus do need to be cautious with TNF blockers as they can exacerbate their disease. Rituximab is considered safer for lupus patients.


Lynne from Edmonton asks: Could you please discuss the link between RA and Fibromyalgia? I have been diagnosed with RA but at times my whole body hurts…just wondering if that might be what I have..

Up to one-third of patients with rheumatoid arthritis may also develop fibromyalgia. As the rheumatoid arthritis gets under better control, your sleep will improve as will your ability to be more active; this should lead to improvement in the more diffuse pain from the fibromyalgia too.

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