Arthritis Associated with Other Illnesses Q & A

Can I have RA plus MS?

I have had joint/tendon pain since an unresolved strep infection a year and a half ago.I continued to have recurring positive streps for 6 more months. It has almost gone away 3 times, then flares back up. Everytime it flares my strep titers go back up, (dNase at 1380 last time), and I get an erythema marginatum rash. I don’t believe that my throat is infected again as I had my tonsils out 10 months ago, (afterwhich I had immediate improvement). If this pain is from the strep, why doesn’t it go away? Everything I read about PSRA indicates that it is self limiting. If it is not the strep, why do the strep titers go up and the rash come back? I am currently taking 3 gm of sulfasalazine an 200 mg of doxycycline per day.I saw great, if slow, improvement when I began these meds. The pain flared when I went off the doxy for a couple of weeks, 2 months ago. I am still experiencing significant pain in shoulder/arm tendons.

I am a 32 yr old man. I have been suffering from cylical (every 4 to 6 weeks)undiagnosed fevers the last 12 years. The only test that has come positive is the test for Rheumatoid Arthritis. Can R.A. cause fever of this kind in me? I do have occassional heaviness and discomfort in my right knee, which disappears with application of pain balm. As my R.A. is not clinically significant, my doctor has not started treatment for it. Will my R.A. get progressively worse ? Doctor, is there any permanent cure for R.A.?

I have read that arthritis and autoimmune diseases can be linked with vitiligo. Is the vitiligo you see with autoimmune diseases tiny depigmented spots (slightly bigger than the head of a pin) and itchy? Do I, as the patient, consult my internist, rheumatologist, or straight to derm?

I saw my internist for a case of sudden onset polyarticular arthritis (though mostly arthralgias) that started about 8 days after onset of a febrile illness that included severe pharyngitis. A strep culture was eventually positive and I was treated with 10 days of amoxicillin. ESR and CRP were slightly elevated. My joint pain continued so I was referred to a rheumatologist who diagnosed poststeptococcal reactive arthritis. RF, ESR and CRP were negative at that visit. My joints were progressively if slowly improving when, at 6 1/2 weeks after the onset of the first illness, I again developed a very sore throat and swollen glands. I started a second round of amoxicillin my internist had given me in case I was exposed to strep again (I have two small children in preschool). Within a few days I experienced a definite exacerbation of the arthritis symptoms–not as severe as the first round but definitely worse. The rheumatologist says he thinks I should be better by now if it was PSRA (I’m now 8 weeks past confirmed strep) and suggests it may be early RA. Is there a usual course that poststrep reactive arthritis follows and how is it usually managed? I can’t seem to find a lot of information about the range of experience with this condition.

Is this also caused by Osteoarthritus or are you just born with it? What are the implications?