Q: I am a 22 years old student suffering from systemic lupus erythematosus (SLE) for the last one year. I have been taking Medrol 4 mg. I consulted a doctor because I had severe pain in my joints and swelling in my fingers and wrist. I also had nodules in my neck region. On taking pain-killer steroids, my pain subsides and I am able to walk but if I skip a dosage the pain becomes too severe. My knees hurt a lot and I feel warm also. I can neither stretch them nor fold them. I have pain in my back too. It is difficult for me to type or read with my head bent for even 10 - 15 minutes. My aunt (mother’s sister) is suffering from rheumatoid arthritis and has got her joints operated and now her spine is bent. Could this be hereditary? My height is 5 feet and 2 inches and weight is 62 kg. I have been putting on weight continuously from the time I started taking steroids. Whenever I go to the doctor for a monthly check-up, he gives me the same tablet again. He says my ESR is normal and I am fine. Why are my nodules spreading and my pain not subsiding?

A:You say that you are suffering with SLE and taking steroids, at the same time you say that your symptoms are suggestive of RA and you are suffering with pains. It is definite that you are having inflammatory arthritis, in which joints are swollen and get stiff more early in the morning and after a period of rest. But there are many causes of this type of arthritis such as RA, SLE and also Seronegative spondyloarthropathy. To find out, we rheumatologists, first find out the type of arthritis by interviewing the patient, a detailed physical examination, and then investigate to find out the particular auto-antibodies formed in the body. Please meet a rheumatologist (joint physician) not a joint surgeon for advanced scientific treatment. I am sure, by appropriate timely treatment your disease, whatever it is, can be controlled and you can lead a normal pain-free life.