Rheumatology Q&A by Dr. Shiel

• I have been diagnosed with polyarteritis nodosa (PAN). How does PAN differ from lupus?
• I have diffuse idiopathic skeletal hyperostosis and was recently told I have more exuberant osteophyte formation. What is this, and how is it treated?
• My mother has rheumatoid arthritis in her feet and ankles. Are there any non-medicinal treatments for RA? She won't take medicine.
• I am a 69-year-old female diagnosed with avascular necrosis of the hip. How is this condition treated?
• I have had arthritis in my hands for several years, in addition to Heberden's nodes. Some of the nodes are constantly very painful and water blisters have begun forming on the nodes. What can I do?
• Will the nodules that occur as the result of RA disappear over time? I have one on my elbow, and another has just appeared on the inside of my foot.
• My mother has a condition in which her fingers turn completely white--especially during the winter--and when the blood returns to her fingers, they tingle. A rheumatologist told her today that she possibly has scleroderma. What is the prognosis and treatment for this disease?
• What causes bone spurs on the spine?
• My husband is 60 and has hand pain. The doctor said it's the beginning of rheumatoid arthritis. Can this be limited to his hands, or does it always progress?
• Can osteoarthritis be prevented?
• I have tendonitis (trigger finger also) in my hands. It seems to worsen after eating red meats. What's the connection?
• My husband has been taking Methotrexate as prescribed by his rheumatologist. However, he is getting abnormal growth/tumors in his hands and wrists accompanied by weakness and tingling. What could this be related to?
• I've been taking Lipitor to lower my cholesterol. Someone told me that Lipitor may help me with my rheumatoid arthritis, too. Is this true?
• Are there any particular foods which should be included or excluded from the diet of an individual suffering from arthritis?
• I have just been diagnosed with Diffuse Idiopathic Skeletal Hyperostosis (DISH). I'm currently taking antiinflammatory medications. Are there any exercises and/or nutritional suggestions that will also help?
• I've been told that I have fibromyalgia. I have to deal with pain on a daily basis, but the pain in my lower back and left hip continues to cause me major problems. My doctor tells me that I can take over-the-counter pain relievers and do some stretching for the problem, but it isn't working. What should I do?
• What is a Yersinia arthritic infection? What causes it?
• I'm a 35-year-old woman of average build and have a family history of osteoporosis. I exercise, don't smoke, and try to eat a calcium-rich balanced diet. What other steps can I take to prevent osteoporosis?
• What are symptoms of ischial bursitis?
• I have UCTD, and I would like to know if UCTD could turn into Lupus or another connective tissue disease.
• My husband was diagnosed with Reiter syndrome in 1962. He has terrible bouts with skin rashes. Will you add some more of the skin diseases that are associated with this disease. Thank you.
• I would like to have some information about the surgical therapy of Raynaud's Disease.
• I have a relative that found out that she has what the doctor has explained as "0-negative arthritis." I have never heard of this kind of arthritis and am wondering if it has a common name. Thank you for your help.
• I have been to many specialists regarding what I believe to be carpal tunnel syndrome. I have had a closed fracture on my wrist and forearm at different times in the past. I do repetitive work with lifting light weight with thumb and forefinger daily. During flare-ups, I can't even hold a cup of coffee or brush my teeth. When visiting doctors, they all have me do standard push, pull, and pressure test against there hands. Also, one poked me with a pin and asked if it hurt. My wrist burns and I have pain and numbness in the whole hand, not just the thumb and 2.5 fingers normally associated with CTS. They all have told me its osteoarthritis with only hands-on evaluation. I have not been to an orthopedic surgeon yet. Is there a certain test I can take to rule out carpal tunnel syndrome?
• I have read in your pages that Aspirin increases uric acid to rise in the blood, and that a rise in uric acid in the blood is the cause of Gout. As I take 75 mg of aspirin every day, will this cause Gout?
• I have been diagnosed with Ankylosing Spondylitis and am currently taking prednisone. The side effects of this drug have become overwhelming and I wish to discontinue use as soon as possible. I have been advised to decrease my medication by 1 mg per every two weeks. I currently take 7 mg a day. 14 weeks is so long. My question is, why is it so necessary to decrease the amount so slowly? And what are the side effects if you decrease at a faster rate?
• I am just about to qualify in therapeutic body massage. I have been asked to massage a colleague. However, she tells me she has "spondylitis" in the 1 and 2 cervical vertebrae (atlas and axis). My instinct tells me that she needs to get the 'all clear' from her doctor. Would you agree with this and can you tell me if body massage can help this condition?
• What causes costochondritis? Is there something she does to aggravate it (like exercise or diet) or is it possibly viral?
• I've been asked to have a facial skin biopsy