A Simple Fall Uncovered Unknown Bone Degeneration

I was diagnosed with rheumatoid arthritis in 2016, about 10 months after I was diagnosed with Crohn's disease — another autoimmune disease centered around inflammation. However, I'm fairly certain I've lived with arthritis far longer than just the last 8 years.

As a child, I'd cry out at night due to the pains in my knees, my hips, my elbows, and my wrists, and the pediatrician made note several times about an increased SED rate on my lab work (noting inflammation). However, despite these indications, I was always written off, told that it was growing pains and that eventually they'd go away.

Suffice it to say, I needed to be the patient advocate I am now when I was about 8 years old.

My RA was considered well-controlled

However, now I have the language and the understanding to apply what I've learned, and to take care of my body in the best ways I know how to.

I've been on a biologic medication that manages both my RA and my Crohn's disease for 7 years now, and for the most part, my RA has been considered to be well-controlled. However, that was based on symptom checking alone.

A CT scan revealed bone degeneration

In September, I took a major fall when I stepped out of my shower and slid across the tile floor. I ruptured my ACL and tore my MCL (the ligaments that hold your knee cap in place). I tore the muscles behind the kneecap, I tore my meniscus (the cartilage that supports the kneecap), and I had small fractures in both my tibia and my kneecap. It was QUITE the extensive damage for what was just 1 wrong step.

In order to learn this information, I had to go to the ER; they only took a CT scan and then referred me to an orthopedist. Then, I had to see the orthopedist, who ordered an MRI, and then that MRI had to be read. The most surprising thing in the MRI results I didn't mention above was the bone degeneration seen in my knee.

Years of RA treatment did not prevent new damage

My doctor mentioned that this was unlikely due to the fall, and that it was more likely due to longstanding chronic inflammation of the joint lining and bone rubbing against bone. He said if he had to guess, he would attribute this to living with years of untreated rheumatoid arthritis.

This felt like a major blow to me — I thought that, with me having been on medication to manage my disease for such a long time, no new damage had occurred, but I also realized that my initial RA diagnosis and treatment in the interim had never required extensive imaging like an MRI.

How did a simple fall cause such severe injury?

These results and facts bring up a lot of questions for me that I might never have an answer to — like how long I've had inflammation in my knees, if there is bone degeneration in other joints, how much degeneration is too much degeneration (a.k.a., when do I need to get worried or seek out additional testing and/or treatment options?).

Was that weakness in my bone structure part of the reason that a simple fall was able to do so much damage in 1 spot?

Has imaging changed your treatment plan?

If you've lived with RA for a while now, have you had extensive imaging done of your primarily affected joints?

I'd be so curious if you wouldn't mind sharing below anything that has been found via imaging that you didn't already know about, and if that has done anything to change your treatment plan or the way that you manage your life and disease.