Does inflamation show on mri?

** Originally posted by GMOM **

After 16 months of mtx for pa, with low back pain as my foremost complaint, my rheumy now wants a mri to check for disc problems. He originally diagnosed pa, undifferentiated lumbar spondylitis, and sacroilitiis. Does anyone know if the inflamation from these diseases will show on an mri, or will it only show disk? I'm so frustrated. If this was a possibility, shouldn't it have been done long ago? The only thing that has changed is that my back has continued to get worse, which I mention on every visit. The answer has always been that the back is the last thing to respond to these drugs. My p has cleared up completely, although it was always very limited. Stiffness in hands and feet is somewhat quicker to clear in the am. But, if the diagnosis on my back is not from one of the auto-immune diseases, I'm not sure the overall result has been worth what I've gone through on these drugs! I really could just scream! (SCREAM!!!!!!!!)
Ok, got that out of my system. Thanks for listening.
Back to original question...does inflammation show on an mri?
Blessings to all of you,
GMom

Report post

13 replies. Join the discussion

** Originally posted by RichJ **

hi gmom,
sorry i can't help much but i can bump you to the top

have a good night all

richard

Report post

** Originally posted by JesseLou **

I asked my orthopod husband your question - he says it would be a "stretch" - that you might see some tissue thickening, and in the large joints, fluid, but HE wouldn't be able to tell that the pronblems in your spine are due to PA. He wouldn't rule out the possiblity that a radiologist or rheumatologist might be able to do so.

Do you really think you'd be better off not taking MTX?

Report post

** Originally posted by GMOM **

Richard, thanks for the bump.
JesseLou, I really don't know at this point. Just don't see that I've gotten much benefit. It sure isn't helping my back. Rheumy shows every diagnosis in his original notes as "mild" or "minimal". Seems like high powered rx for mild or minimal. Pre-existing fatigue has gotten so much worse with mtx, but all doc says is that I don't take enough mtx (17.5) to cause that effect, and up the dose of folic acid (up to 10 on mtx days). Mobic helped my back, but both docs felt I was developing an ulcer, so now on Celebrex for last three weeks. As soon as I switched, my back flared. Which led to me asking for a back injection (which rheumy has pushed from the start). Which led to him scheduling an mri. His request for mri states "siatic pain" which I've never had. So I'm not even sure the mri will be done on the part of my back that actually hurts...sacroiliac and low lumbar.
OK, whine, whine, whine. I will now arise from the "pity chair" and make an appointment to go over all of this with my pcp.
Thanks for listening and for asking your spouse. I bet he gets tired of hearing these questions. Maybe he should start a web site of faqs that our docs don't answer and make some $. I'd pay for answers when I hurt this bad.
Blessings,
GMom

Report post

** Originally posted by Saxmom **

When I was first Dx'd Low back pain was a huge thing for me. The Dx of PA is still my major problem, but MRI's and CTscans were all done in order to see the extent of damage done to the lower spine. They found three bulging discs and a lot of damage done by the PA. My rhuematologist sent me to several different specialists who mostly said there wasn't much that they could or would do because of the PA. At least now they have a baseline of where my back was 9 years ago which can at some point be helpful I suppose.

So all that is to say that they may not be changing your Dx, just checking to see how much damage has been done. Once they know that they can decide what else, if anything, should be done. Also, I would suppose that the doc put sciatica down so that the insurance company would go ahead with the test.

Just relax some and trust your doctor, if you really don't feel like you can trust him, then try to find someone that you can trust. This is an ongoing desease and you must work with the doctor who you feel most comfortable with, or else you will always be second guessing.

Good Luck,
Paige

PS Don't forget that the pain you experience will work on both your body and your mind to wear you out! Fatigue is something that we all complain about and rest is something that we have to find time for. With PA you have to really play it day by day as too how much rest you need. Somedays you will hardly need any and others you may not feel strong enough to get out of bed.

Report post

** Originally posted by GMOM **

Saxmom
You are so right about the trust. My rheumy is hard to trust because he is a total "non-communicator." But I realize I either have to trust his reputation, which is extraordinary, or change docs. I have questioned this dx and treatment for over a year, and it is time to stop being such a ninny. I had not considered that the mri could show any possible bone change due to pa. I read your note to my husband, and we have both decided to schedule the mri, get the results, and see where that takes us. If not satisfied with the treatment at that point, I'll get a second opinion. Thanks for the input and the new perspective.
Blessings,
GMom

Report post

** Originally posted by patti2957 **

I don't take enough mtx (17.5) to cause that effect.
Blessings,
GMom

Do you mean 7.5? If you take 17.5 mg and your rheum says it's not enough to cause fatigue, read a couple other threads about fatigue and mtx that are hot now. Maybe we're all a bunch of weenies but you'll find you have a lot of company! I take 12.5 to 15 mg and hate, hate, hate it!
patti

Report post

** Originally posted by GMOM **

Patti, Nope. 17.5 is correct. He really blows that off as too small to cause fatigue. I don't mention it anymore because he wants me to up the folic acid from 6 mg to 10 mg on day before, day of, and day after mtx. All that does is blow me up like a balloon! So I just accept that taking mtx costs me at least 2 days of fatigue a week.! Have scheduled mri; will see where it all leads. Thanks for your support.
PS: I had a frozen shoulder (adhesive capsulitis) in 2003. Not thought to be related to pa, but my shoulder was completely immobolized, frozen in place. This causes excruciating pain when you recline, even slightly. So I slept for a year in a recliner, 2 to 3 hours at best. Had a year of pt; surgery to break the shoulder loose; then sat in a therapy contraption that moved my arm in ways it didn't want to go, 6 hours every day. After watching this for a year, my husband says there is no way I qualify as a wimp...But this danged pa still gets the best of me some days. It's more the frustration than even the pain.
Being able to share on this board keeps me sane..OK, almost sane.
GMom

Report post

** Originally posted by californiahiker **

You can have back pain from PA, and it can also be due to other causes.

I have degenerative disk disease, and rheumy said it's not from my PA. I believe him cos I'm a nurse and worked ICU for decades, I know what I lifted!

However, my back is not the only thing that hurts, I have hips, hands, feet, and one ankle affected also.

As far as the fatigue and dose of MTX being dose related, well, I also KNOW that I had tons more energy before I started MTX, and my dose is 15 mg. No doctor, no matter how smart, can tell me that the fatigue and the time I started the MTX are sheer co-incidences. They don't have my disease, they don't know what I feel, so who are they to tell me how I should and should not feel?!

I think 'though, that most of us in here who are fatigued from the drug would also be fatigued without the drug... (maybe not quite as much)... pain does that to a person. It's there all the time, you hardly ever get a break from it, and sometimes you don't sleep well, sometimes you can't think straight, it's just always there. It really wears a person down. No doctor has a right to invalidate your feelings about that!

I have not had a pain free day since I got this disease some 20 plus years ago. I might have had a couple of pain free moments, and they were drug induced. Once I had a dental procedure done, and the dentist had given me some Demerol pills to take when I got home. So I took them, and for about 10 minutes before I went to sleep I felt nothing, no pain at all. And I remember thinking, oh, what a wonderful feeling this is, no pain, wow!

Oh well. I feel pain, so I'm alive, right? :rolleyes:

Report post

** Originally posted by carscheles **

Hi GMOM,

I'm kind of new here but I thought I could offer my experience.

I had full spine MRIs that revealed significant "Facet Hypertrophy" at various levels. That's why my Neurosurgeon sent me to a Rheumatologist, because Hypertrophy = inflammation.

So to answer your question, yes, inflammation CAN show up on an MRI.

Good luck and God bless,

Carol

Report post

** Originally posted by GMOM **

Thanks, Carol. Just got my results from mri: "minimal degenerative disk damage." So I guess the dx is back to pa.
I appreciate everyone's input as I worked through this. Going back for second cortisone injection Friday..first one didn't help much. Then wait to see rheumy for regular appointment end of May. Current treatment isn't helping my back at all. So we'll see what he suggests then.
Blessings,
GMom

Report post

** Originally posted by janelee **

Even if it is minimal...I am sure it still hurts. Are they going to treat it as well as the PA?

Report post

** Originally posted by GMOM **

All he said was to come in for another shot if I wanted. I want! Got the impression that the pain is not coming from disks. So the only thing to treat is pa. But he told me from the start that mtx probably won't help my back. You know him...I won't get any answers until next regular visit, end of May.
So I'll get the second injection, and wait. lol
GMom

Report post

** Originally posted by MissAngie **

Hi, I haven't posted here in a while but decided to read a little tonight. I just had to respond here because I went through very similiar circumstances. Low back pain has been a big issue with my PA although I have other areas affected also. I was never completely comfortable with the first rheumy that I saw. He ordered an MRI and my spinal results were identical to yours. I always felt like my pain and fatigue were being dismissed. After having pain that continue to get worse all the time and seeing the rheumy for 2 years, I finally got fed up. His reputation was exceptional but I just wasn't happy with him. I decided to see an older rheumy that someone else suggested. That was the best decision I ever made regarding my treatment! The new rheumy took everything I said seriously, never made me feel uncomfortable and gave me hope that things would get better. Unfortunately, after seeing him for nearly a year, he had a stroke and had to retire. I was left looking for a doctor again so I started calling rheumy's and asking questions. Since I had seen a good doctor, I knew what I was looking for. I got lucky and found another excellent rheumy on the first try but I was prepared to make visits to several if necessary. My doctor now has always looked at my SED rates (blood test to measure inflammation) along with my symptoms. When my lower back is really flaring up I can hardly bend or flex (and he asks and checks that). When mtx didn't resolve my pain and inflammation, my doc started me on additional meds. I have had to try several combinations but the doc worked with me until we found what works for me. My pain is almost gone now and my SED rate very near normal. I still have some bad days but there are more good days now.

I guess the point to this long message is this - if you aren't completely comfortable with your doctor and are not seeing results then go for that second opinion. And a third if necessary. PA can be managed successfully. It didn't happen overnight for me but once I found good docs I always felt like they were working with me to achieve a goal.

I hope you find relief.

Angie

Report post

This discussion is closed to replies. We close all discussions after 90 days.

If there's something you'd like to discuss, click below to start a new discussion.

Things you can do

Support the National Psoriasis Foundation

Help the National Psoriasis Foundation reach its goals and support people like yourself by making a donation today.

Donate to the National Psoriasis Foundation

Discussion topics

Additional resources

Community leaders