r/Rheumatology

So. I’m 29 year old active male 190 lbs lean. I don’t drink, eat very healthy. High protein diet etc. workout 4x per week.

I have always struggled with intense lower back and neck pain since I was 16. As I get older, my joint pain in wrist, shoulder, and back continues to get worse.
My psoriasis is on my groin area, eyebrows, and scalp. I’ve managed it but every year gets worse and when flairs, can be really painful and itchy.

I just started a gluten free diet as I heard that could help.

My biggest concerns is that the skin rashes are getting to the point where it’s affecting my personal life.
The shoulder and wrist pain is significantly reducing my strength and range of motion in the gym.
And the morning stiffness is really difficult to push through- especially my lower and mid back. Takes about an hour of walking and stretching for the pins and needles to go away in my next and back after I wake up.

The Dr. has recommended I get on a biological/ monoclonal antibody like Rinvoq or Skyrizi because it’s a chronic condition and the concern is long term joint damage that could be irreversible.
I’m very holistic and try to avoid medications and shots/ concerned about known and unknown side effects especially because I am a highly sensitive person.

Can someone share their experience with these drugs or natural routes? Anything that’s helped?

Hi! I’m a 28F and the long story short is I’ve realized recently that I might have something rheumatological. I’m looking for a sanity check — if this sounds like something I should pursue a referral and rheumatology consult for, or if I’m truly just injury prone and unlucky lol. For some context, I’m normal weight/on the smaller side, and always have been:
- At 17 years old, the back of my right heel became red, swollen, and painful. Good old Google told me it was “pump bump”… even though my shoes had been broken in months ago. Hurt a LOT to have any pressure on it. Developed the same on the left side. No running or anything that explained this, so I thought it must have been the shoes. It resolved on its own after like… 1-2 years? Now that I’m in healthcare, I realize the spot was where the Achilles inserts into the heel.
- lots of random tendon injuries over the years that didn’t make sense (I just seemed so injury prone). For example, i ran *slightly* longer one week and boom, suddenly I had quad tendinitis. Another time, I fell and injured my right shoulder, stopped lifting due to this, but soon after, developed tendinitis in my left rotator cuffs as well.
- developed SI joint pain in both sides 5 years ago. At the time, I was running a lot, so it seemed to make sense? But it would flare on and off over the years, even as I reduced my activity. It also wouldn’t be consistent - sometimes on the left, sometimes on the right. Pain has been constant through since I got sick a few months ago with some respiratory virus (no GI symptoms).
- also started having more lower back pain and stiffness over the years. Chalked it up to scoliosis and getting old. I feel so stiff especially in the morning/after prolonged sitting. My physiotherapist has noticed that my range of motion has decreased over the years.
- foot pain that I thought was normal/running related, but even when I’m not running, I can’t stand for more than like 20-30mins without pain in my heels and forefoot, and feeling like I’m walking on pebbles. It’s especially bad in the morning.
- Figured out that my “stubborn eczema” might actually be psoriasis (saw a patient with psoriasis and realized - hey that looks exactly like my neck rash) but haven’t seen a derm yet

Sorry for the wall of text! But yeah, I’m in training in healthcare lol and what made all of this click is I did a rotation in rheumatology - but I’m not sure if this is just me being a typical healthcare trainee, or if there is something.
I did get some bloodwork and SI joint xrays done - bloodwork was all normal (including HLA, inflammatory markers, ANA, RF), and X-rays were read as normal.

Would appreciate any input!!!

Hello- I’ve been the rheumatologist recently and he diagnosed fibromyalgia because my mom has a hx. I have plethora of autoimmune diseases in my family- hashimoto, graves, lupus, rheumatoid arthritis, and PMR to name a few

Symptoms: daily migraine, constant neck and shoulder pain/stiffness, orthostatic hypotension, general feeling of malaise / like i have a low grade fever, joint pain, restless legs

All my lab work comes back generally fine. Ana negative, rheumatoid panel negative.

However my CRP recently came back at 13 (was never tested prior) so my pcp wants me to go back to rheumatologist. I know this can be just general inflammation. I wasn’t sick at all with this lab test.

That being said, I am 33 y/o female. My symptoms line up almost perfectly with polymyalgia rheumatica(which my maternal aunt had) But I don’t want to look silly by bringing it up to them knowing 1) it’s mostly in elderly population and 2) I’m obviously not the expert. So, I’m wondering the general thoughts in rheumatology- will I be laughed away by asking this or is it a worthwhile avenue to consider? Thank you!!

Saw a rheumatologist for the first time today she stated that since I haven’t had a good response to Meloxicam that I don’t have AS or axspA (she said people with axspA and AS show significant improvement with NSAIDS). While walking around I feel almost no pain. I wake up every night at 3 am with pain and have to flip over to go back to sleep. I have stiffness for around 2 hours every morning. Went to the ER 10 days ago they gave me prednisone and my symptoms were 75 percent gone but came back after I finished the 7 days of it. I’m just getting worse my chest tightness and neck tightness is horrific. She said it would also have to show up on an MRI for them to diagnose Nr-axspA. I left the appointment crying because I can’t do normal daily tasks, I can’t sit up long enough to do my homework so I now have to drop out of school, I’m in so much pain, my pain is taking everything away from me I don’t know what to do.

Some background- I’m 28 years old, had dactylitis September 2025

Couldn’t sit down starting fall 2025 and still can’t. Pain went from SI joints and all the way up to cervical spine.

Imaging- xray lumbar mild osteoarthritis in SI joints

Lumbar MRI- L5-S1 facet arthropathy

Pelvis MRI-Small focal marrow edema laterally at the femoral head and neck junction of the left hip

Chest, and neck X-rays are fine.

Crp and ESR Normal

Complement C4-high

DS DNA-High

Negative for HLAB27 gene

Hi guys, anyone has rheumatology questions, exams or questions banks?

Need to train and learn more.

Thanks!

About a year ago, it started with my fingertips and the tips of my toes going numb. At first, I honestly thought it was from working too hard or overuse. Ibuprofen helped in the beginning, so I didn’t think much of it.

Fast forward about six months, and things got worse. My hands and feet were constantly going numb, with a pins-and-needles feeling that was always there. It became painful and hard to ignore.

Three weeks ago, it reached a point where I just couldn’t take the pain anymore. I went to the emergency room three different times on three consecutive days. Finally, they were able to review my lab results, and my ANA came back abnormally high. On the third ER visit, they ran more tests and confirmed it is scleroderma.

Since then, things have continued to progress. My ears are constantly ringing, I have headaches, pain in my back and sides, chest discomfort, and digestion problems.

Right now, I’m trying to get in with a rheumatologist, but it’s almost impossible to get a sooner appointment. The wait times are long, and I feel stuck in the middle of it all. In the meantime, I’m wondering what I can do while waiting. Any advice, experiences, or suggestions would be really appreciated.

I have been ill for many many years, I have had many blood tests, gone too many specialist , and it has always been hard to get answers . the last year has been unbearable with so many different health issues, but just being in the sun for even just a few minutes, my body gets very ill and I can’t handle it for more than a few minutes. Lupus popped up in my blood test. as positive but they said it was it currently not active so they can not treat it unless it pops up as positive AND that is currently active . Has anyone else had this issue? what were you able to do in able to do to get treatment ? thank you in advance 🙏

So earlier last week i posted about how frustrated i was with my pcp. She diagnosed me with hypermobile arthralgia, which i felt was wrong because its a symptom of HEDS/HSD. She did the evaluation for it, including the beighton score, which she failed me at because i got a 4/9.

The problem i have with that is that she didnt test me correctly. At least not from what ive seen in other specialist and doctor evaluations. Then, because i dont have any hernias or prolapses, and the giant papule thing i have on me feet "dont count" i failed feature A according to her. My skin isnt very stretchy either, but i bruise pretty easily and get scratches from the dumbest things. There is also the striae marks on my hips that ive had for ages, and the sunken in scars on my legs and forehead (not achne related) and a high roof in my mouth. The dr dentist also had a hard time with my wisdom teeth as they were soft tissues impacted, and growing sideways from what i was told.

Not only did she not test me righ, but she didnt complete the evaluation as its written. She should have asked about my history, (the five questions for if you miss the cut off by 1 point). She told me i failed to meet all the criteria, but didnt tell me which criteria i did and didnt meet for feature A. Nor did she ask much a about my family history. (No one had been diagnosed with HSD/HEDS, be we've all been told by drs that were double jointed) but the other symptoms i have dont count towards the diagnostic critia.

It doesnt help that the rheumatologist i saw told me kn person that it was indeed HSD/HEDS, but didnt write that in the clinical notes. She wrote hypermobile arthralgia instead. So the pcp dismissed me.

I was able to message my rheumatologist and she did get back to me, saying she would make an adendum to the notes and resend them to my clinic. But her clinic wont let her make an official diagnosis for some reason, and for uniformity among her 9 other peers they use hypermobile arthralgia. I dont understand why when HSD/HEDS is not quite the same as hypermobile arthralgia. (The later being a symptom of the former) she also said something along the lines of "you dont need a diagnosis unless you want to get disability" in my visit at the rheumatologist clinic. During the phone call she said something about it not qualifying for disability or something.

To be honest, i dont really care about the disability aspect. But im pretty sure my mother had it, and my brother likely does as well, (but he has been having a rough go of things as well) so knowing my family history, and having things documented for my children is important to me. I also want to get tools so i can be functional to care for my children, and to be taken seriously by my pcp. And my obgyn should i have anymore kids. I was told my by obgyn that round ligament pain is normal, but she didnt under that my hips were even worse than normal and my sciatic nerve would slip into the joint when it moved and get stuck there. (Ive been told that cant happen, but the lighting shooting pain says otherwise) and i dont think bellyband are helpful for that problem.

Also recently i injured my knee by standing. I was sitting, i stood up, and my knee rebelled. Pop snap and pain. I ended up going to the er because my foot went numb. Thankfully they were really nice, and didn't dismiss me. They did referral me to a sports med therapy, but they do exercise based therapy, and i felt that would be unwise.

The good (i guess) news is that at the end of the month, i have an apt with another pcp for a second opinion. Ive already sent him a message about my situation, and called the risk management of my clinic to express my concerns about the whole thing. And about the other other dr who told me i couldn't have HEDS because its so rare. (Lol, EDS is less comon, but HEDS is under diagnosed, or called fibromialga from my understanding). I hope this new pcp I'm going to visit with will take me seriously, especially with the amendment to the clinical notes from the rheumatologist. I have also requested genetic testing for the other EDS types just to rule them out.

My ANA and rheumatoloid arthritis tests came back normal, (my labs are always close enough to normal that the drs arent concerned) and i dont have carpel tunnel. So thats also good.

I’m currently working as a nocturnist/hospitalist on a J1 waiver in a non-academic setting, with my waiver ending in 2027. Life has honestly been very difficult personally and professionally over the past few years, and I initially took this job mainly for stability and visa reasons. Over time, though, I’ve started feeling very stuck and worried that I’m limiting my future.

Interestingly, during the past several months, I’ve developed a real interest in rheumatology after taking care of patients here. I genuinely enjoy the complexity and diagnostic side of the field, and for the first time in a while, I feel motivated toward something academically again.

The difficult part is that I’m in a non-academic environment, so I don’t have much mentorship or guidance around me. I’ve recently started reaching out to professors and programs at other universities and have gotten a few responses and possible starting points, which gave me some hope.

I’m now trying to figure out the best path forward. I’m considering applying this cycle just to see where I stand, although I still need to take/pass ABIM boards. During residency and noctunist work (very heavy 12 hour eith xc snd 10 pts daily) went through a lot personally and honestly could not prepare properly for boards, but I do think it’s very doable now if I structure my time well over the next year.

Part of me wonders if it would be smarter to focus on boards first and apply in 2027 instead, but regardless, I want to start building my profile now so that by next year I’ve actually accomplished meaningful things.

I would really appreciate advice from anyone who transitioned from a non-academic hospitalist position into rheumatology fellowship.

Specifically:

How do I realistically strengthen my application from a non-academic setting?

Are there research groups, societies, foundations, virtual collaborations, etc. that are helpful to join?

What kinds of projects are realistic to start with (case reports, reviews, retrospective studies)?

How important are connections/networking versus publications?

Is it still realistically possible to match coming from my situation?

Edit.

Please don’t comment telling me to only focus on boards first and think about rheumatology later — because with a fixed J1 waiver timeline, I realistically have to prepare for boards while also planning my future and building toward what I want to do next, since I cannot stay indefinitely in my current job.

Hi all,

I’m posting because I feel overwhelmed, scared, and honestly pretty alone in this.

For a while now, I’ve been dealing with crushing fatigue that feels way beyond just being “tired.” Some days even basic things like standing, going up stairs, concentrating, or getting through normal responsibilities feel exhausting. I also have weird physical symptoms that seem to come and go (body aches/sensitive skin, brain fog, lightheadedness, feeling feverish at times, neurological-type symptoms in my hands/feet, etc.), and I’m in the middle of trying to figure out what’s going on medically.

I recently had an abnormal ANA (1:320 speckled), but I still don’t have answers yet, and specialist appointments take forever.

What’s really getting to me is how much this is affecting my ability to function like a normal person. I’ve had trouble keeping jobs because I genuinely don’t know from day to day whether I’ll be physically capable of showing up and functioning. From the outside I’m sure that looks flaky, lazy, anxious, dramatic, whatever—but internally it feels like my body is betraying me and I’m trying as hard as I can just to keep up.

I keep questioning myself because without a diagnosis, part of me wonders if I’m somehow exaggerating or failing to cope, even though another part of me knows something is clearly wrong.

Has anyone dealt with something similar—especially unexplained fatigue/chronic illness symptoms before diagnosis? How did you manage work, finances, and the mental side of not knowing what was happening? Any advice for getting through this would mean a lot.

Thank you!

Hello,

I have not been diagnosed with Sjogrens but am thinking this is a potential impending diagnosis. I have strugged with TMJ since 2016, ear pain for about 8 years with constant crackling and popping, IBS for 2 years, acid reflux for 3-4 years, and most recently severe migraines. I do have dry mouth as well as dry ears and nasal passages.

I will be seeing a rheumatologist for the first time in 2 days, and am wondering if there are any recommendations anyone has on questions to ask!

Hey guys! I (22f) do not have an official lipedema diagnosis, but I do have a large amount of the symptoms. What I do know is that I have stretchy ligaments and wide hips which has caused me knee pain since I was 14. An ortho specialist said I have Patellofemoral Dysfunction/syndrome ( i don't run) and my knees don't track properly because of puberty and stretchy ligaments which is what causes the pain. That's just a bit of context.

I am going to see a rheumatologist next Wednesday and I want to mention lipedema to them so they can go through steps specific to that to either diagnose it, or rule it out to send us down another path. It's so hard though because I don't want them to think I have just "diagnosed" myself from things I've seen online. That's not at all what's happening I just need answers because it's painful and confusing and has been for the majority of my teen and young adult life.

From what I've tried to find, rheumatologists are able to diagnose lipedema because it it has to do with inflammatory and autoimmune factors, if I have that right? Has anybody been diagnosed by a rheumatologist? If so, what did you say, how did you mention it to them to get the investigative/testing steps moving? Any recommendations on how to mention it or if rheumatologists are able to or are familiar with lipedema, would be really greatly appreciated. I'm so tired of being in pain all the time and not knowing wth is actually happening in my body.

Thanks guys:)

Hi everyone. I am honestly just looking for some support and to hear from others who have been through something similar.
My child is very young and has been on Dupixent for atopic dermatitis for about 18 months. At the 12 month mark his ANA was completely negative. Sometime after that it turned positive.
His current picture:
• Persistent swelling and stiffness in his finger for over a year
• Very mild tenosynovitis in two fingers on MRI — no other signs of inflammation or joint damage found
• Ankle tenosynovitis last year
• Skin history with photosensitive features
• Elevated eosinophils and basophils persistently over several years
His labs:
• ANA positive in April, was negative until August 2025
• Anti-RNP: 1.2 in April 2026 → 1.6 in May 2026 (normal 0.0–0.9)
• C3, C4, CH50, ferritin all normal
• Inflammatory markers normal
What worries me most:
The anti-RNP went from 1.2 to 1.6 in just about 4–5 weeks. Has anyone ever seen their levels trend upward this quickly? Is this considered a significant jump or normal fluctuation?
We have a rheumatology appointment coming up and I am also wondering whether Dupixent could be driving this through the Th2 to Th1 immune shift since his autoantibodies only appeared after starting it.
I am a worried parent just trying to understand what we are dealing with and find others who have navigated this. Any experiences or insights are welcome. Thank you. 🙏