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Sacroiliitis vs degenerative discs #280043
03/11/18 04:23 AM
03/11/18 04:23 AM
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Barbara57 Offline OP
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Barbara57  Offline OP
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Been a while since I posted but I follow the group.

I’ve been having pretty severe lower back, buttocks, pelvic and hip pain. The pain is at its worst in the morning and gets better with movement unless I do too much. Recent CAT scan showed a collapsed disc at L4-L5 that may be pressing on the nerve roots. However, my rheumatologist spoke with the radiologist who then “reformatted” the scan and said it shows bilateral sacroiliitis.

If the pain is from the disc my only option is surgery which I really don’t want. If it’s sacroiliitis then I would opt for more aggressive treatment for my AS. I’m HLA B27 negative with high inflammatory markers and a history of sacroiliitis at diagnosis.

What is the latest on the best form of scan to visualize the SI joints? Should I assume that the new look at the CAT scan is definitive or push for an MRI?

Thanks all:)


Barbara/Age 65. Diagnosed with SpA in 2009. Unable to take NSAIDs due to gastritis. Failed sulfasalazine, Humira, Actemra, Enbrel, Rituxan, Orencia and Xeljanz. Currently taking Cosentyx and prednisone.
Re: Sacroiliitis vs degenerative discs [Re: Barbara57] #280049
03/12/18 06:45 PM
03/12/18 06:45 PM
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SouthernMoss Offline
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An MRI will show inflammation and soft tissue changes better than an x-ray or cat scan. An MRI is especially useful for people who do not have significant bone damage yet, because with MRI you can see the inflammation in the bone that cannot be seen with x-rays or cat scans.

However, in your case you already know that you have sacroiliitis, both from the recent cat scan and from the imaging you had at diagnosis. So you would need to ask your rheumatologist whether any information the MRI might provide would make any difference in the treatment he/she would prescribe.

Does your rheumatologist think the pain is from the SI joint or from the disc?


Ginny - 57 year old female
Dx with USpA in March 2013; changed to AS in July 2015
Iritis and Scleritis
unicompartmental knee replacement June 2014
MTX, Humira, Cyclobenzaprine, plus Celebrex as needed
Supplements: Folic Acid, Vitamin A, Vitamin D, Calcium, Fish Oil, Melatonin, Culturelle probiotic
Re: Sacroiliitis vs degenerative discs [Re: Barbara57] #280082
03/19/18 05:27 AM
03/19/18 05:27 AM
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Posts: 194
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Barbara57 Offline OP
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Barbara57  Offline OP
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Joined: Sep 2009
Posts: 194
Thanks for your response. My rheumatologist thinks the pain is from the SI joints. Of course the orthopedic surgeon seems to think it’s from the discs. I started Cosentyx recently and am hoping for a decrease in the inflammation.

Does sacroiliitis come and go throughout the course of the disease?


Barbara/Age 65. Diagnosed with SpA in 2009. Unable to take NSAIDs due to gastritis. Failed sulfasalazine, Humira, Actemra, Enbrel, Rituxan, Orencia and Xeljanz. Currently taking Cosentyx and prednisone.

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