Rheumatoid Disease – Again with the Elbow!

Today, I saw my rheumy, and he showed me the radiology report from the MRI I had done on my elbow.  Let’s just say that it said nothing good about it.  Edema in the bone, lots of fluid, partially torn ligament, etc….  Their impression was that this had RA written all over it, but I still haven’t been buying that fully.

When I injured my elbow (7 years ago, carrying my son in his infant car seat), my elbow went POP, hurt like and SOB for about 5 seconds, then didn’t hurt, but didn’t ever straighten again.  Granted my RA was really bad at that time, but my elbows actually didn’t bother me in the least bit.  The pop didn’t bother me until about 2 years ago, when I started getting more aggressive with an exercise program.  It hasn’t really hurt during the day time, but when I exercise, it hurts at night (when I lie down, specifically) and locks up so severely, that sometimes I can’t rotate it (at 90 degrees stomach to outside).  It wakes me up frequently, and has been a near nightly problem since they tried to straighten it in the MRI machine a few weeks ago.

Apparently that pop was a tear in the ligament, but now there’s all of this fluid and swollen bone stuff.  Who knew?  The joint is not warm or red like a usual RA-impacted joint would be for me.  Anyway, the radiologist recommended an ultrasound guided draining and injection, as the joint appeared so severely impacted that he wasn’t even sure that they could get a needle in there.

I love my rheumy.  Did I mention that the orthopedic surgeon still hasn’t called me with any MRI results?  Anyway, he did the ultrasound thing, got it all lined up, and got the needle in.  Guess what!  No fluid came out.  He verified via the ultrasound that he was in the right spot, and he was.  If I understand this correctly, this could mean one of two things.  1- this could be severe ongoing RA (I don’t think so) or 2- this could be an old injury that didn’t heal properly, and the fluid has thickened such that it won’t come up the needle (that’s what I think).  He successfully injected it with a steroid, and we’re going to see if it does anything.

Yesterday after the procedure, it bothered me quite a bit (even in my muscles around my elbow).  Last night was the first night in a long time that my elbow didn’t wake me.  Today, it’s feeling a smidge better, but hurts with some reaching backwards things like getting my seatbelt on and washing my hair.  The risk here is that the ligament tear could cause a change in my elbow that could cause wear and tear damage on the joint over time or that the joint could become unstable as some of my other joints have (swollen for so long, then not swollen, and all the ligaments are stretched out).  Time will tell.  I thought the procedure was worth the risk, as it seemed to be worsening after several years of not having any problems (other than it didn’t straighten all the way).  Hopefully that hardened fluid will work its way out???  I’m not even sure what the steroid will do, but I guess that’s the goal.

I have to get the “all clear” from the orthopedic surgeon on the torn ligament.  Is it safe to exercise?  Does it/can it be repaired?  Of course, he hasn’t returned my rheumy’s calls either.  Sheeesh.

I’m sure there will be more to come on this story, but the moral is… don’t blow off a “pop” in your elbow, even if it doesn’t hurt anymore!

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