Hi all,

I'm hoping to get some feedback from the folks here who have
experienced, or know someone who has experienced, something similar to
what is happening to me now (and for the last 4 months). Before I
describe it I should let you know that aside from the aplastic anaemia
and the side effects of the treatment for it, I do not have any blood
work that would account for what is happening.

It started out four months ago as pain in the middle three toes of each
foot and only at the first metatarsal/phalanges joints. Then it spread
into the right heel and the left ankle (though the left ankle already
has serious problems, with near full collapse of the talar dome from
osteonecrosis and poolry healed tendon and ligament damage). Next it
spread into both knees, with the right knee being worse (about 6 weeks
ago we found more 'subclinical' osteonecrosis in the right proximal
tibia below the knee joint, but that pain I'm experiencing feels like
it's in the joint itself over the cartilage). Then it spread to both
index fingers and my left elbow and wrist (MRI found some osteonecrosis
in part of the lunate bone in the left wrist).

The pain seemed to subside a bit after about a month. Then my lumbar
spine started hurting, deep into the bones and around the facet joints
between the vertebrae. An MRI showed patchy marrow signature, but I
don't think this is unexpected with aplastic anaemia and the treatment
I'm on. We're following this up. However, there was no osteonecrosis or
any other reason for the pain that was visible on this MRI (and the
radiologist took a good look, too, and wants more information about my
medical history: he's fascinated by the patchy marrow signature). This
pain was VERY bad. Then, after 2-3 weeks, it started to ease. The pain
in the toes, right heel, and both knees was still there, but less severe
now.

Unfortunately, the pain moved to the right sacroiliac joint and was
quite severe. An x-ray showed some signs of long term stress to the
joint (probably from my odd walk due to the collapse of the left ankle),
and I'll find out the results of a bone scan tomorrow, but the pain came
on suddenly and for no apparent reason, not slowly over time. I could
stand, but not lean over even slightly. Once standing, I was pretty much
okay. But standing up from a seated position was intensely painful.
Laying down in bed or sitting up fram a laying position hurt even worse.
 The pain from rolling over at night while I slept was quite bad and
ALWAYS woke me. Then, it started to ease after a month.

Now, my toes on both feet, both of my elbows, and both of my knees are
hurting quite badly. The joints feel hot to the touch, and I've been
running a low grade fever for a while now (37.5 C). I was wearing a
wind-breaker jacket one day, and when my wife touched my arm at the
elbow she was surprised to feel the heat coming through the coat...but
only at the elbow. The joints feel inflamed and even a little
pressurised. There's a slight rubbing/grinding feeling in the elbows
when the pain gets worse. The right SI joint has started becoming
slightly more painful again, and facet joints in the lumbar spine are
hurting again now, too.

I really don't know what the heck is going on, but the pain is wearing
me down and restricting my movements (more than they already are). I
cannot take any opiate based painkillers as they cause side effects that
could potentially cause greater health problems, and panadol (tylenol)
doesn't help the pain (and it's not the greatest thing to be stressing
my already stressed liver with). We're thinking about starting me back
on celebrex, but I'd like to know what the heck is going on before we
treat the problem! I'm used to osteoarthritis from known causes, but
this is something new to my experience.

Based on the pattern of symptoms and the lack of evidence for a cause
(seronegative for rheumatoid factor), does anyone have any idea what
this might be?

TIA,

Ari