Sigh, It hurts.

September 30, 2012 9:17 PM

Rheumatoid arthritis onset after seve infection? Possible?

I was diagnosed with fibromyalgia a year ago and have been on meds since (Cymbalta, Gabapentin, Tramadol, Mobic). Memorial Day weekend I was scratched by my cat. I ended up in the hospital for a week with bacterimia, cellulitis, and a septic knee. After the infection, I seemed to go into the worst fibro flare of my life and it's still seemingly going on. But on reflection, the symptoms aren't so in line with my typical fibro stuff. I have a lot of joint pain, which I never had before. It's bilateral. My hand, fingers, wrists, feet and toes are especially painful. I tried to put on a ring the other day and found my finger was too swollen to get it on (sob). My shoulders are so painful, it's difficult to do my hair or write on the board (I'm a teacher). I do have a family history of RA (father, aunt, great aunt: all on the same side of the family).

You are not my doctor. I am going to see my rheumatologist tomorrow, but I wanted to be armed with some information going in.

posted by kathrynm to health & fitness (9 answers total)

Sometimes infections can trigger reactive arthritis.
posted by Logic Sheep at 9:59 PM on September 30, 2012 [1 favorite]

I have FM, diagnosed about 20 years ago.

The worst flare I every had was several days into an antibiotic course for pneumonia, I had developed after surgery. The pain in my knees, ankles, feet and wrists was bilateral. It was a severe crushing pain. But, I had no swelling, redness or warmth in any of the joints. I could hardly move, I have never been in so much pain in my life. I called a friend sobbing and crying. She brought me to the Emergency Room with all of my medications. Evey joint was x-rayed, blood tested for everything (RA, Gout, etc). Everything looked normal.

Doctor surmised that it was a really bad flare due to the stress of the surgery, general anesthesia and pneumonia.

When my shoulders get really sore, I stand under a hot shower and just let the water beat my shoulders and back.

Good luck,
posted by JujuB at 10:00 PM on September 30, 2012

I have had flares very much like this, off and on, since my late teens or early 20s in reaction to infections of varying severity. I've never met all the criteria for RA, but it's clearly autoimmune in nature (and autoimmune diseases run in my family, too). My worst flare-ups were eventually brought down by temporary courses of Prednisone. (You may already know this, but just in case not: if you do go on Prednisone or any other steroids, make sure your doctor has you taper off the meds -- don't just go off them all at once, otherwise you can have an excruciating rebound flare, as I found out the hard way.)
posted by scody at 10:46 PM on September 30, 2012

Another person here who thinks it sounds like reactive arthritis. Rheumatologist is the right person to see.
posted by molasses at 4:33 AM on October 1, 2012

My RA (or probable RA, since I've been diagnosed only with "probably RA" due to not having any of the appropriate markers in my blood nor any major visible swelling, only inflammation in x-rays and lots of pain) has been known to get worse in times of stress including sickness. Given your family history of RA, I wonder if fibromyalgia might have been an incorrect diagnosis and what you have is actually RA which has been set off into a flare by the cat scratch?
posted by springbound at 6:41 AM on October 1, 2012

Also: Really they don't know what causes RA. Some theories do involve an instigating infection, though. So yes, to my understanding: it's possible.
posted by springbound at 6:45 AM on October 1, 2012

Let your doctor know if you were taking a fluoroquinolone such as Cipro for your infection. Musculoskeletal pain is a possible side effect.
posted by Wordwoman at 9:58 AM on October 1, 2012

Hmmm, I was on Cipro, but have been off for a good 2.5 months. I'll mention that to him next week though.

I saw my rheumatologist today and given the location of my pain, the infection and my family history, he decided that it's likely RA. I had blood drawn and will get the results next week (when hopefully my boss will have given me my insurance card). We'll go from there. He did say it is possible to have fibro and RA together and can occur (in his experience) about 30% of the time.

Thanks hivemind.
posted by kathrynm at 10:33 PM on October 1, 2012

I should follow up: No RA according to the blood work (numbers elevated, but not to the level of a true diagnosis). My inflammation markers are all elevated. I saw an orthopod today to follow up on some knee surgery and he looked at my hands and feet and thinks I should have additional testing done at one of the larger hospitals.

Bah humbug.
posted by kathrynm at 6:23 PM on October 13, 2012