Infection in jaw

[Margrete]

Hey everybody.

I just came back from the hospital, a regular control, but the MR-pics showed infection in my jawbone!
anybody heard of this?? the doctors are not sure it's wg. either my wg symptoms are very unique, they said, or I my have ANOTHER autoimmune dicease. heh.

anybody?

[Sangye]

What kinds of specialists were consulted? It would be worth getting an oral surgeon's input, or at least an ENT. Any infection in bone needs to be addressed ASAP and thoroughly. The jaw bone has some unique qualities (compared to the rest of the skeleton), so a doc who specializes in that area is necessary. Is it painful?

[jola57]

Margret, yes see a oral surgeon soon, bone infection is serious especially in our situation. Did you have a tooth cavity in that area, do you get regular dental checkups?

[Margrete]

Sangye, they allerted an jaw orthopedic, or what its called.. will probably see him in a couple of weeks. The doctors mentioned that they could treat it with cortisone-shots. the infection is in the joint in the jaw, next to the ears.
And about the pain.., not VERY painfull. When my sinuses were worse, it hurt a lot in my jaw too, so I thought it was another sinus infection. But I can chew and eat just fine, feels like my ears and sinuses are infected.

Jolanta, my tooths are just fine. I think... Haven't seen a dentist since I got WG (2,5 years ago) .. but no tooth cavity.

I'm very curious if this is WG. But I haven't found anything or heard anything about WG and jaw. Do you think it could be some kind of reactive infection, since i've had so much troubles in my ears and sinuses?

[Sangye]

Is there any way you can push for a quicker appointment? Any infection in an immune-compromised person can spread like wildfire, and so close to the brain, eyes? The jaw joint is actually the front of the ear canal. Also, the cortisone shot makes no sense to me. It's an antiinflammatory, not antibacterial. And, it's immunosuppressive, so it's likely to increase infection. The jaw joint is unbelievably tiny and relies on precision balance to work well. If it gets damaged by shots, cortisone, infection or scar tissue, it can leave you with a truly miserable problem.

[andrew]

Yuh huh...I echo the calls for an earlier appointment. Needs to be seen to quickly to prevent more complications.

[Twice]

And, it's immunosuppressive, so it's likely to increase infection.

To an extent, yes, but cortisone injections are targeted and short term. Although pred is immunosuppressant, it can be very useful as a 'first line of defence' against an infection. If I have an infection beginning, I usually take a single big chunk of pred in an attempt to hold it off: a sort of adrenal burst. P'raps.

Same thing for high-dose Methylpred at the beginning of treatment, I guess.

[Sangye]

It's a tightrope to take a burst of pred-- balancing the pro-infection qualities with the pro-adrenal ones. Doing so when I had pneumonia almost killed me, but there are times when it certainly works, like with you, Twice. The difference here is injecting it into a joint vs a systemic dose. The joint cortisone won't circulate and affect the adrenals. Because it stays within the joint capsule, it also makes that environment like closed petri dish. Both the infection and the cortisone would be stuck in there, duking it out. An existing infection in a joint is a major contraindication for cortisone injections.

[Margrete]

but how, exactly, can the doctors be sure if it is an infection and not inflammation? both crp and sr were ascending, but not more than 55/40. and my temp around 101. and today, after increasing my pred, I feel sooooo much better.. hmm! and it really doesn't hurt very much. wouldn't it hurt more if it was serious?

I really don't know what to think..- but the whole jaw-dilemma kind of scares me, so maybe I should get a quicker appointment. is inflammation in jaw joint common?

thank you very much for all your replies! you're all experts compared to me..

[Sangye]

Margrete-- sometimes a diagnostic study (eg MRI) will show shadows that indicate infection. Inflammation looks different. If the radiologist read it as infection, I'd go with that. All bone/ joint infections are very dangerous. Please get in quickly to have it evaluated properly.

As far as pain, the jaw joint is so tiny that if it were just inflammation, it would be pretty painful. I've had that joint involved with Wegs and it's bad. However, infection is not necessarily painful until it advances or does other damage. (Lots of people have quite advanced tooth infections without knowing it) Your fever is a big clue as well. 101 on immunosuppressants is nothing to sneeze at, pardon the pun.