Spondylitis Association of America Forums General Discussion General Message Board for Ankylosing Spondylitis and Related Diseases How often do you get imaging done?

Hi, I was wondering whether your rheumatologist arranges xrays from time to time to check on progression/damage?

My rheumatologist has only ever sent me for imaging during my diagnosis (xrays of lumbar spine and sacroiliac joints plus scanning my hands and feet) and chest xray before starting humira,

My family doctor arranged for me to have a neck xray when my neck started spasming, before I went to a physio. He also arranged a bone density scan given my family history etc, where they commented that the bone density seemed fine but I had what looked like sclerosis in my hips that should be followed up, but rheumy just said the scan wasn't diagnostic...

I've never had my thoracic spine xrayed or scanned and that and my ribs/sternum are among my worst areas.

My rheumy does x rays yearly, but truthfully I think it's because she has her own machines in her practice. She does the x rays but doesn't go over the results with you until next appointment which can be 6 months later.

I've not had imaging done since I was diagnosed. My rheumy said that if I had loss of range of motion or new symptoms we would x-ray, but if ROM is all normal (except my neck, which has not changed) there is not much point. Since I am already on biologics, x-rays would make zero change to my treatment.

I know many would disagree and get routine images. Still, I really don't want 50 years worth of yearly or bi-annual x-rays. X-ray exposure is meant to be limited over time and there are lots of recommendations to try to reduce overall exposure to x-ray and other radiation-based images.

The risk of repeated x-ray is small, but there IS a risk. And if it would not change treatment, then my feeling is what is the point? If it WOULD change treatment, that is a whole different story.

My SI joints are fully fused already. If I had fusion in my spine, I would presumably lose ROM.

I have not had any x-rays except for the initial SI/hip x-rays when I was first dx'd. Although I prefer to be cautious about the amount of exposure, I have had symptoms for many years and would really like to know the condition of my spine. I suspect if my symptoms worsen, my dr would order more images of some sort.

I had a full set of spinal xrays done during diagnosis. Then last year I was sent for a nuclear bone scan. Now that things have ramped up and worse then I have ever been I am being sent for an MRI and just had a full set of follow up xrays done...

If you have any choice, then I'd always go for MRIs over any form of radiation- as long as that was the best sort of imaging for the job. In particular I wouldn't want to be having xrays done as a routine and regular follow up.

But, having said that, I did have three SI xrays in succession just over a year apart - the third because the first two had shown changes, but still not quite enough to get a diagnosis. In fact the third did give me a diagnosis from a private rheumatologist, but the NHS rheumatologist doesn't see that its enough yet. I did that because my GP could order xrays but not MRIs, and also because at 58 I knew that my lifetime xray dose to date was actually very low. If I'd ever had CT scans, then I'd not be so quick to have another xray.

So, how often? Rheumatologist did MRI in 2011. He may order another soon - I think because I alerted him to new stuff that seems to be coming from my thoracic spine which wasn't imaged back in 2011. He wouldn't have seen a need to repeat it otherwise.

I suppose you have to ask what you expect to happen after you have imaging done. What is it going to change? If its just to see what it looks like, then that isn't enough. If changes might mean that your treatment changes then that might be a good reason.

I just had an x-ray done and my Dr. was surprised to see how much my neck was fused. I knew I had neck fusion but my c-spine looks like a stack of Oreo cookies. No bend at all. My thoracic is showing signs of fusion. Oh joy. This was the first full x-ray that I had done. Does it change my treatment...well she did add a new medication. :-(

Nope. But I have no damage showing up on imaging (yet?) - so every couple of years one of my docs will get the urge to get a new MRI or whatever to try to crack the code....

Rheumy did some x-rays (lumbar and SIJ) on the date of my referral in 2009 and none since. I suppose if something needed x-rayed, he would do it, but he doesn't do it routinely.

Pain doc has done MRIs on every spine level, plus SI, to assess for problems based on symptoms, but only repeats for new-onset symptoms.

I get MRIs periodically to monitor my progress. It has been able to show inflammation around my t-spine at SI joints in addition to erosion at the SI and bone growth at the t-spine.