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Possible AS and MRI in early stages #280024
03/04/18 06:21 PM
03/04/18 06:21 PM
Joined: May 2016
Posts: 11
London, UK
elbmow Offline OP
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elbmow  Offline OP
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Hi. I've been treated for suspected psoriatic arthritis for about 18 months, but I have no psoriasis. Now I think AS is a possibility and wanted to know what other people think.

I've been getting lower back and hip pain on and off for a couple of years now. For the last few months it's been getting worse and waking me up in the very early morning, I can't turn over and am very stiff. As soon as I get up, it eases off and I maybe get a little pain during the day if sitting for a while. I often get pain in the buttocks on the same side, knee, and sometimes the pain goes down the back of my thigh on the same side. Hip x-ray was normal. I've also been getting bad achilles and right shoulder pain.

There's a tender spot in my right SI region and my lower back and hip often crack and pop when I get up from sitting.

I have had pain and swelling in a few fingers, pain in my feet and ankles, heel pain (right at the back so it's uncomfortable to walk shoeless), and also get a stiff and crunchy/popping neck sometimes. Blood tests are normal. I've been taking sulfasalazine for a few months and the finger/hand pain has improved but this does not seem to help my back, hip, or achilles pain (which is just getting increasingly worse).

I'm having an MRI of my pelvis soon. I don't tend to have pain once I'm up and moving around, and sometimes have good days when the pain goes away completely. So, if the morning pain is caused by sacroliliitis/AS, will the MRI show anything if I'm having a good day? And how likely is it to pick something up if it's in its early stages?

I had a bone scan a couple of years ago which didn't pick anything up in my back, just inflammation in my ankles and feet. But I've had pain in the lower back/hips waking me up for about 18 years - it used to be only when I slept in a different bed from my own. No matter how comfortable, I would wake in the early morning in agony. It was only in the last few years when I started to get other joint problems and my back/hip started getting worse that I even considered this could signify a problem. I always assumed I was just fussy about my mattress.

I'm a woman in my late 30s. I haven't had an HLA B27 test. Any thoughts would be appreciated.

Thanks.

Re: Possible AS and MRI in early stages [Re: elbmow] #280025
03/04/18 09:05 PM
03/04/18 09:05 PM
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Winston Offline
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MRI is becoming the gold standard for diagnosing and monitoring AS, especially early AS. This article does a pretty good job explaining what can be seen: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3403247/

Re: Possible AS and MRI in early stages [Re: elbmow] #280035
03/09/18 03:39 AM
03/09/18 03:39 AM
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MartinMMM Offline
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Apparently Psoriatic arthritis can occur without skin manifestation.
https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis

Re: Possible AS and MRI in early stages [Re: elbmow] #280039
03/09/18 06:07 PM
03/09/18 06:07 PM
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Posts: 303
Washington, D.C.
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ljohnsy Offline
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Hi!
My situation sounds similar to yours. I'm sorry you are experiencing pain in so many places! I know how frustrating it can be to not get complete relief for all the joint pain.

I was originally diagnosed with AS 9 years ago but since then several doctors have questioned the diagnosis. My bloodwork has always looked normal and an early MRI showed nothing out of the ordinary (SI joints). I am HLA-B27 positive. My symptoms have been consistent over the years. Mostly lower back pain, rib pain, neck pain and recently, pain in foot and finger joints. So I had an MRI a few months ago. The radiologist said this: There is the suggestion of subchondral
sclerosis and early iliac erosion at this level of signal abnormality. This is an indication of active disease, although it is mild.

So I am glad that I finally have something concrete to "prove" I have AS, although I am not happy about having AS, obviously. If your disease is active, the MRI should show something. I hope you get some answers and some relief.


Laura -- age 40, diagnosed with AS 11/09. Mom of 2. Currently taking Humira.
Re: Possible AS and MRI in early stages [Re: ljohnsy] #280041
03/10/18 09:19 AM
03/10/18 09:19 AM
Joined: May 2016
Posts: 11
London, UK
elbmow Offline OP
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elbmow  Offline OP
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Thanks for the comments.

My joint pain looked like various things at various times as it developed but, now it's established, some kind of spondyloarthropathy is the only thing that makes complete sense (I understand psoriatic arthritis and AS are in the same family).

I appreciate why it takes so long to get a firm diagnosis, though I can't understand why my rheumatologist ignored my back complaint for so long. She never examined my back. She's blamed my symptoms on everything from flat feet to depression, but refused to believe the pain was inflammatory in nature. I'm only having an MRI now because she went on leave and I saw someone else who joined the dots in one appointment.

My concern is that my bone scan a couple of years ago apparently didn't show anything in the pelvic region, so I think the chances of anything progressing in two years to the point where it would show in an MRI is slim. But I know for sure there is something wrong with my back and/or hips. It's just frustrating having endless inconclusive tests that don't progress your treatment.


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