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#215484 - 08/20/11 05:38 PM does inflammation show on xray/mri
dgopal Offline
Registered Visitor

Registered: 05/24/10
Posts: 144
Loc: Greensboro, NC
I was just wondering if inflammation (feet and kjnee) will show up on xray or MRI if there is no damage due to it yet....

i have been suffering from more than a month...just got the xrays done and waiting for result.....

im worried that my Dr is going to say every thing is normal and that they do not see any inflammation...

WHat in world is causing the pain then if its not mechanical ( should hav shown up in xray/mri) and if theres no visible inflamation !
_________________________
Female, 30, Diagnosed with AS in April 2010
symptoms controlled with enbrel

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#215485 - 08/20/11 05:47 PM Re: does inflammation show on xray/mri [Re: dgopal]
sequoia
Unregistered


it is most distressing but the answer seems to be generally no, not every time. the mri has a better chance of showing the inflammation, but the damage is what shows up on the xray. meaning, the fusing of a tendon to the bone it attaches to during the enthesitis process. when this occurs in the si joints, there is xray evidence that the pelvis shows one continuous bone, when, if the si joints weren't fused/fusing, one would still see the actual joint clearly.

this does NOT mean there is no inflammation. when you can point to the exact spot that hurts and it is over the si joints, the spinal connections, or shoulders, etc, it is fairly certain you have some inflammation. it is the bother to find what it is due to.

i think you would also find a negative if you were on dmards and/or preddy because both reduce inflammation. it is important to get "before" treatment and "after" treatment mris/xrays to see if any change occurs.

also, be sure to keep a copy of all of them.

take care, prayers and peace, sequoia

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#215495 - 08/20/11 10:07 PM Re: does inflammation show on xray/mri [Re: dgopal]
NotMeToo Offline
Registered Visitor

Registered: 07/12/04
Posts: 1016
Loc: United States
A plain x-ray will not show inflammation, but may show inflammatory damage in the form of sclerosis, erosion or ankylosis. It may take years for the damage to become visible on x-ray.

An MRI will show inflammatory damage, but may also show evidence of inflammation in the form of bone-marrow edema and/or subchondral inflammation. An MRI is considered more sensitive then an x-ray and may show evidence of inflammation sooner.

It is possible to have pain, stiffness and other symptoms of AS before (sometimes long before) radiologic evidence of the disease. Is the doctor who ordered the x-ray your Rheumatologist?
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Not Me Too!

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#215499 - 08/20/11 10:48 PM Re: does inflammation show on xray/mri [Re: NotMeToo]
taberge Offline
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Registered: 05/25/09
Posts: 458
Loc: Sulphur,La. USA
X-rays show damage.
MRI's with a contrast agent have the ability to show inflammation.


PS. The radiologist reading these images has to be trained to see such damage or inflammation. Sadly most of them are not because they are drilled in trauma first and arthritic changes are but the footnotes at the back of the book.


Edited by taberge (08/20/11 10:53 PM)

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#215501 - 08/20/11 11:53 PM Re: does inflammation show on xray/mri [Re: taberge]
seekonk Offline
Registered Visitor

Registered: 12/06/10
Posts: 1254
For the reason Taberge explained, it's a good idea to ask for a copy of the images in case you have to ask a second reading. In my experience, they are happy to provide the images to you. My first corner-shop radiologist was clueless and saw nothing; I looked at the images myself afterwards and after comparing with examples of AS on MRI from the internet I thought I saw something suspicious and pointed this out to the doctor, who got a second opinion - the second radiologist saw bilateral sacroiliitis with active inflammation and longer-term damage.

But for this vigilance on my part, I would still be undiagnosed.


Edited by seekonk (08/20/11 11:57 PM)
_________________________
Spondylitis since '08, finally diagnosed Feb '11.
Enbrel 50mg/week.

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#215512 - 08/21/11 09:19 AM Re: does inflammation show on xray/mri [Re: seekonk]
dgopal Offline
Registered Visitor

Registered: 05/24/10
Posts: 144
Loc: Greensboro, NC
thanks all for your inputs...the Dr who ordered these is a rheumatologist and she is the one who Dx me with AS after looking at my SI joing MRIs..

These xrays are for my feet and knees to see whats going on there and reason for pain there..
she told me that they will do a MRI next if nothing shows on the xray...

so im hoping some thign good comes of all this and my pain days are numbered !
_________________________
Female, 30, Diagnosed with AS in April 2010
symptoms controlled with enbrel

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#215513 - 08/21/11 09:23 AM Re: does inflammation show on xray/mri [Re: seekonk]
aslee9 Offline
Registered Visitor

Registered: 08/28/08
Posts: 2119
Loc: michigan
I'm always confused on the xray thing. When I go to my pain management doctor (Back Pain Specialist) they do the injections under xray guidance. When I question what they are seeing on the xray, they will point to black foggy looking area and say that's from the arthritis. I will see a perfectly normal looking spinal area and then areas that are shadowy looking. I've also seen this when they injected my cervical area for the first time. I only had the left side done since that was where I was having the most pain and swelling, but the doctor also said look, you can see damage on both sides.

I always wonder what that shady, black area is. Anyone here know?


Edited by aslee9 (08/21/11 09:23 AM)
Edit Reason: typo
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Ann
HLAB27+
62 years old flexeril, tramadol, tramadol er, percocet, lidoderm patch, flector patch, voltaren gel + other meds for other conditions + lots of vitamins


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#215519 - 08/21/11 11:21 AM Re: does inflammation show on xray/mri [Re: aslee9]
sequoia
Unregistered


hey ann, just want to say, i know very little about what shows on an xray, as far as shadows goes. what i read the other day, don't recall where, some medical site. anyway, if the si joints are fused - fused with bone material- the area appears like the rest of the pelvis, whatever color that is, i think bone shows white in xrays. if the si joints are not fused, ie not full of bone, then they show up as a shadow.

i think this is true as the first time i saw my joints, i could see most of the joint. not on the latest films. now the bone goes across.

xrays are tough. and perhaps that is the reason the regular radiologists get our readings so wrong so much of the time, like seekonk said. they just don't know what they are looking at.

s.


Edited by sequoia (08/21/11 11:21 AM)

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#215552 - 08/22/11 05:02 AM Re: does inflammation show on xray/mri [Re: ]
dgopal Offline
Registered Visitor

Registered: 05/24/10
Posts: 144
Loc: Greensboro, NC
Its really sad if we have to wait around for yrs , letting the condition progress and waiting for the damage to take place so that theres some thing to show !!
_________________________
Female, 30, Diagnosed with AS in April 2010
symptoms controlled with enbrel

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#215626 - 08/23/11 09:55 AM Re: does inflammation show on xray/mri [Re: aslee9]
JenInCincy Offline
Registered Visitor

Registered: 05/19/08
Posts: 13278
Loc: Cincinnati, OH
Originally Posted By: aslee9
I always wonder what that shady, black area is. Anyone here know?


Ann, IDK, but am very curious!! Your doc seems open and willing to explain things, like mine is; next time you're there, ask him/her - and be sure to tell us what the doc says!
_________________________
Jen, 42, happy partner of James and Moma to Evan, 14, & Lucy, 12.5 (Crohn's dx @ age 3; on Remicade since April 2010.) I take piroxicam, Flexeril, & Nucynta ER nightly. 3 anti-TNFs didn't pan out for me.

"Science is the father of knowledge, but opinion breeds ignorance." -- Hippocrates

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