I am 22 yrs old and was just diagnosed with inflammatory arthritis.I am 22 yrs old and was just diagnosed with inflammatory arthritis.

It only affects my knees and primarily just my right knee. I started having problems with knee pain when I was 13. At 14 I dislocated my right patella. Dr's were unable to reduce my patella, so I ended up in emergency surgery to put it back in place. Before this I had general pain in both knees. Since the first surgery, I have had total of 5 other surgeries on my right knee ( lateral release, tibial tubercle osteotomy, and scopes). My left knee has never dislocated but has subluxated numerous times. I have had a lateral release and a tibial tubercle osteotomy on it as well. Back in 2008 before one of my scopes my ortho tested my blood for arthritis and crp was the only thing elevated and it was only ever so slightly elevated. I then started to have problems with the right knee again this past March, so the ortho tested my blood again and this time the crp was the only thing elevated, but much more elevated than in 2008. The ortho then sent me to see a rheumatologist, who now believes I have inflammatory arthritis. Could this be a juvenile form vs. adult form? I also have had problems with my incisions stretching out over time and also with my last scope, one of my incisions stretched out tremendously during the surgery its self.

Answers from our Doctors

Dr. Ted Mikuls says:

Unfortunately, it is not uncommon for patients to have symptoms for months to even years due to inflammatory arthritis before a formal diagnosis is made. This relates primarily to the fact that most forms of inflammatory arthritis are clinical diagnoses - meaning there is no single laboratory test or x-ray test that is "diagnostic". Thus, it is certainly possible that this could represent a juvenile onset form of arthritis if indeed there was an inflammatory component to this with its onset at age 13. In retrospect, with the information provided, it is impossible to know for certain. You must keep in mind that an elevation in the CRP test (a measure of inflammation) is very non-specific. Health care providers may use several other clues, including results from other laboratory and imaging tests, to identify the exact cause of joint problems. Tests that can be helpful in differentiating inflammatory arthritis from non-inflammatory arthritis (like that due to mechanical causes) can include select auto-antibody tests, imaging tests including x-ray and advanced imaging such as MRI, analysis of fluid taken from the joint, and microscopic examination of tissue resected during prior surgeries or as part of a biopsy procedure.

Answered on: Monday, June 14, 2010 - 11:54


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