Spondylitis Association of America
Posted By: ZeldaLady Anyone have mri without contrast for AS - 09/06/19 10:56 AM
Hi there. So recently I’m having quite a flare up. I seen the rheumatologist a couple weeks ago. It’s only my second visit with her. I’m not sure how I feel about her yet. She did order several tests: x-ray of my collar bone with steroid injection, mri and x rays and blood work for vitamin d. I’m happy about that but here’s the thing, I’m not crazy about having the contrast dye for the mri. I know for most this isn’t a big deal but I’m extremely hesitant when it comes to medicine and being that it can have terrible side effects I would rather have the mri done without the contrast.

My question is, has anyone had an mri without contrast that was able to detect ankylosing spondylitis? When I called the doctor and told them this the receptionist was pretty nasty with me and said that the doctor wouldn’t be able to see what she’s looking for and my insurance might not cover it unless I get it and why can’t I just take Benedryl and have it done.

My mri is 2 days from today so I’m hoping someone here has some input before then. Anyone have an mri without contrast that was any help?
Posted By: RAHMBA Re: Anyone have mri without contrast for AS - 09/06/19 07:01 PM
I'm not able to answer your question regarding dyes. I do know it's important to do a T1 & STIR. The favorite source of information on MRI & spondylitis is from Dr. Maksymowych. this is a terrific webinar he did on the subject: https://www.spondylitis.org/Seminar...nd-spondyloarthritis-webinar-maksymowych

hope it helps,
Thanks for the info and reply.

I had my mri today and they ended up doing the contrast. They said I had to have it to see what they need to. So I got it and my results are already available online. I haven’t heard from the doctor yet but read the results and pretty much googled my through interpreting it. It basically says it doesn’t show any inflammation in my SI joints. I’m so confused. My back hurts so badly and had for years and it’s clearly in my SI joints. It showed mild degenerative disk disease in L4 and 5 which has some change from last year. So I understand that as arthritis that has gotten a little worse since last year. It also showed possible intraosseous hemangioma. I think this is a benign tumor on L4.

If anyone understands any of this any guidance would be awesome. Has anyone else had a mri and it not show inflammation. I’m really confused. Only thing I know for certain is my back hurts. A lot. I’ve basically been living on a heating pad for weeks.
Posted By: Alice10 Re: Anyone have mri without contrast for AS - 09/09/19 12:14 PM

I'm not sure my reply is going to help you much, but I did have 2 MRIs to confirm/rule out AS and both came back negative. They haven't used any chemical (contrast or else). My MRIs were full spine and SI joints.
I have debilitating pain (back + several other joints) when I'm not taking NSAI, but since we don't see anything on the MRI and I'm HLA B27 negative, I don't "officially" have AS (and I'm not allowed to receive the biologics for example).
So, to answer to your question, it's possible to have AS and have clear MRIs.
When I got my MRI results, I've had mixed feelings... On one hand, I was relieved that there was no damage (for the moment) on my joints. But on the other hand, I wanted a "proof" that my pain was real...
Have you had the HLA B27 genetic test?

Posted By: Winston Re: Anyone have mri without contrast for AS - 09/09/19 07:02 PM
ZeldaLady, see http://enthesis.info/spondyloarthritis/back_pain_and_normal_mri.html

My MRIs (with contrast) are always normal too. Nevertheless, I have a formal AS diagnosis, and my insurance company never balks at paying for my biologic therapy.
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