You have a localized lipodystrophy of the skin above your knee. Localized lipodystrophy presents as isolated depressed areas with induration and indentations in the extremities and other parts of the body. These lesions may expand and, sometimes, spontaneously disappear. Patients generally do not have any underlying diseases or associated symptoms at the time of presentation. Surgical treatment with collagen injections or fat ingections has been successful in some cases.
What was your ESR? Usually the erythrocyte sedimentation rate (ESR) is elevated in approximately 90% of patients with rheumatoid arthritis. There are many conditions associated with a positive ANA e.g. rheumatoid arthritis, scleroderma, lupus, infectious diseases, subacute bacterial endocarditis, Sjogren's syndrome, autoimmune thyroid disease, and liver disease. Also there are some medications that can cause a positive ANA. Many healthy people have a positive ANA. Approximately 5% of the general population have a positive ANA but less than 1 in 1,000 have lupus. Approximately 5% of patients with rheumatoid arthritis are ANA positive and rheumatoid factor negative. Most people with rheumatoid arthritis eventually have a positive rheumatoid factor, although it may be absent early in the disease.
Treatment of rheumatoid arthritis:
Ibuprin, Advil, Motrin 200 to 800 mg every 8 hours unless you have a history of GI bleeding then take Celebrex 100 to 200 mg twice a day.
Rheumatrex 0.2-0.4 mg/kg once a week.
Arava 100 mg once a day for the first 3 days followed by a maintenance dose of 10 to 20 mg daily.
Imuran1 mg/kg per day for 6 to 8 weeks then increase by 0.5 mg/kg every 4 weeks until response or dose reaches 2.5 mg/kg per day.
Azulfidine EN-tabs 0.5 to 1 gram per day; increase weekly to maintenance dose of 2 grams per day divided twice daily.
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