Hand x-rays and burning in ligaments?

If hand x-rays are negative does that rule out PsA?

Has anyone had episodic tearing or ripping pain that feels like burning in their muscles? Maybe they're tendons or ligaments? What could this mean?

Thanks!

Early PsA or well controlled PsA wouldn't necessarily show much on x-rays. There is inflammation prior to damage. But you may not PsA affecting your hands in particular.

Also, you asked about tearing or ripping pain. . . .For me, this seems to be associated with tendon inflammation. The muscle involvement portion for me is tightness, not burning, due to tendon inflammation. I do a lot of stretching to help deal with this.

My x-ray: No significant degenerative changes. There is mild periarticular osteopenia. Not sure what that means.

My hands definitely aren't the worst areas affected by arthritis. It is worst in my low, low back, neck and shoulder. Internist wants to rule ont PsA because my hand x-rays are negative. He did notice the pitting on my fingernails and toenails and separation of nail from nail bed, but wasn't impressed. I'm on 40mg prednisone and I am currently having ZERO pain. Yay. He said my response to it indicates an inflammatory type arthritis, but I start my taper tomorrow. Not looking forward to it (actually terrorized by the thought), but I know prednisone is a fickle b**** and a double edged sword.

I feel the muscle tightness you speak of. But I also have the burning or ripping pain if I'm not properly stretched out before getting up and getting moving.

Thanks so much for your input. I really appreciate it!

Victoria

Over 30 yrs my "worst joints" have changed. My hands are being affected now (swollen, stiff, etc) and they never have before (besides two joints that needed fusion but weren't painful, they just deformed with no other issue). So just because one area of the body is not affected now, does not rule out PsA, or guarantee that that area will not become severe at some point.

Also, my tendon pain has REALLY ramped up in the past 6 months. As an example, when the tendons in my left calf are inflamed, I can stretch all day but the area becomes swollen, hard, and when I walk it feels like the tendons are going to rip right off the bone. I also get inflammation of my IT Band (outside of knee) that burns like fire.

Super fun times, isn't it? lol

IT band is a bugger for me right now along with the inside of my left elbow...golfer elbow is what it is called.

Hi, negative x-rays usually means there are no bone changes(erosions) that’s all. It doesn’t mean negative PsA, all my hand pain is tendon based even the permanent swelling of the base of little finger isn’t bone and doesn’t really show on x-rays.
The docs are usually looking for erosions to classify and diagnose the type and aggression of your PsA.
I am diagnosed with primarily non-erosive PsA although I do have old erosions in my shoulders, and my last x-rays showed possible damage to my spine so due MRIs tomorrow.
The pain I have is primarily from tendon and ligament, at the end of the day pain is pain, whatever its source.

I’ve got pain all over, but it all started in my feet about a year ago, the hands, low back and neck. Now it’s creeping into ankles and wrists and elbows. My diagnosis was "barely made’ as all blood work was normal. Just had pain in joints and a few pits in nails. Never had ski involvement. It was plan old X-rays which showed sacroiliac joints were total fused in my back. The list of diseases causing this is small, but just to make 100% sure he was treating PsA, he got an MRI of my worst painful joints, my feet. It’s a special high-resolution MRI and the inject contrast via IV as well. PsA inflames the tendons and ligaments where the insert on bones. Left untreated, or with progression, erosion of the bone at these inflamed sites. Those may be seen on plain, old X-rays. But early disease like mine can only be picked up on MRI. If you are doubting the diagnosis and want clarity prior to starting potent, potentially dangerous (and expensive) drugs, get the MRI for peace-of-mind.

Regarding burning muscles, yep! Calf muscle and Achilles burn like fire! Apparently Achilles is a very common site of inflammation in this disease. Stretching might help me a bit. But I still hurt. Only on Ceiebrex at the moment. Starting Enbrel in next couple of weeks (just had hip surgery yesterday). I hope I’m a good responder! I want remission!

Good luck. Get the MRI!

I had physical therapy for my right knee last summer. The MRI didn't really show anything. I think it was the IT Band. It feels like a rug burn on the outer side of my lower knee. My neurologist thought it was part of my peripheral neuropathy but I think now it is just inflamed tendons. Obviously, the Humira and MTX does not help with that - bummer...

My first xrays showed a little fluid in the joints but no real joint issues at all and yet I could barely walk from the car to the dr's office. That burning pain is the worst. You could totally be having PsA because the inflammation is what you notice first.

Darn. I had hand xrays done two months ago and they show no bone degeneration. They swell up and get really stiff. I was hoping that disqualified me for Psa. Sigh. I also didn't realize how much more tendons played into the Psa equation than other RA. Interesting. Reading about you folks and your issues, well, pretty much sounds like me. Finally got into a rheumy for this month. Guess I can stop planning to use the hand thing as a justification for why I don't have this stuff.

You are all very helpful, thank you. My hands are not the worst affected, they're hit and miss at best. But I have had sausage digit on right hand, middle finger. It didn't last very long. I also have peripheral neuropathy, but this tearing, burning pain isn't the same. This is all post strep infection from back in the 1980s.The arthritis hit me like a freight train. My spine is a mess, but internist says I have wear and tear problems. My first encounter with spine problems was when I was 23-24 years old. Narrow disc space in my neck. My low, low back is the worst. Facet joints are a mess among other things.

Is it surprising that prednisone would work for PsA? I'm having no pain whatsoever. Letting out a little short-lived yay!

Victoria

New here but as a healthcare professional I am wondering why fellow PsA sufferers are getting all these Xrays?

It seems to me we should be requesting ultrasounds or MRIs instead to avoid the buildup of radiation in our bodies.

I have read and been told by my Dermatologist that there is a specialized ultrasound for just this purpose.

After being exposed to multiple Xrays with NO DX for my hip condition I finally was Xrayed standing up rather than

lying down . There it was clearly visible bone on bone and loss of catilage. xrays do NOT show cartilage as I understand it .Evidence is obtained from the bone on bone positioning clearly seen in the testing. Frankly , I am annoyed that I have been given so many useless Xrays in the past.

I was told that it tightens the ligaments. That is why so many PSA patients end up with plantar fascitis. They verified mine through x-rays of my lower back and my toes are extremely affected. My hands have progressed to the point that one knuckle is completely degenerated. Major swelling in that hand most of the time. Hate to be negative but we can’t afford to not get treatment as soon as possible to avoid as much damage as possible. Best of luck.

I have some very severe joint degeneration, but when they start xraying me standing up things moved quickly to surgery, yeah. But I've often wondered why they don't do MRI as well, Since there's obviously something significant going on, but xray is not the way to see it...? My hands are also hit or miss, some days swollen like sausages, unable to hold things, some days boney as ever! Weird.

So I guess Psa is the tendon disease, as that has long been my bigger issue. My ligs and tendons are ALWAYS inflamed and painful.

Thanks to an artificial knee from years ago, and all the xrays, I figure I'm one plane ride away from growing tentacles!

Yes ligaments are affected by PsA .Have presonally had trancient pain and tightening of various ligaments in my leg and arms. Has anyone here heard of this specialized Ultrasound used to DX PsA. I think it was developed by a PsA Dr in Northern New Jersey.

http://www.hindawi.com/journals/cdi/2011/390726/

"Plain radiographs are the standard technique employed to document the typical proliferative and destructive bone lesions of PsA and are, therefore, very useful. However, they are insensitive to the soft tissue changes (peripheral joint effusion, synovium proliferation, structural abnormalities in tendons and entheses, tendon sheath thickening, and bursitis) that are the only signs of early arthritis [18]. Ultrasonography (US) with high-frequency probes (>10 MHz) is increasingly being used for its ability and sensitivity, compared with clinical evaluation and X-rays [19–22], in evaluating soft tissue involvement both in early inflammatory arthritis and in late disease [21–25]. Power Doppler sonography (PDS) affords visualization of small vessel flow, showing soft tissue inflammation and disease activity in peripheral arthritis [19, 26–32]."

Also please read...............

http://link.springer.com/article/10.1007%2Fs11926-■■■■■■■■-6?LI=true

Every time you are Xrayed your body holds onto and builds up radiation. Not so very good!

MRI is an expensive test and Insurance companieds dictate protoclols for usage.many times Drs have to argue with and justify the testing .Ultrasound ,on the otherhand is not so expensive and is becoming increasingly a test of choice for PsA DX. CT scans expose you to very high doses of radiation. As always risk vs benefit is always the question .

Personally I ask for testing that will cause the least amt of exposure to radiation now.

http://link.springer.com/article/10.1007%2Fs11926-■■■■■■■■-6?LI=true



Redhedgurl63 said:

I have some very severe joint degeneration, but when they start xraying me standing up things moved quickly to surgery, yeah. But I've often wondered why they don't do MRI as well, Since there's obviously something significant going on, but xray is not the way to see it...? My hands are also hit or miss, some days swollen like sausages, unable to hold things, some days boney as ever! Weird.

So I guess Psa is the tendon disease, as that has long been my bigger issue. My ligs and tendons are ALWAYS inflamed and painful.

Thanks to an artificial knee from years ago, and all the xrays, I figure I'm one plane ride away from growing tentacles!

It has actually been something that I just think about and am stunned that they are soooo quick to throw you into xray. I've had at least a dozen in the last 7 years. Insane. I may ask the rheumatologist about ultrasound this month. My first appt with her is on the 30th. I saw a rheumy when I lived in China, but it was horrible. I had huge bright red bumps on my hand and he dismissed them as tho they meant nothing... hmmmm. He seemed to know or care very little. Hoping this new lady has some smarts and can give me some answers.

I have told doc after doc that my tendons and ligaments are the worst part of it. Had two synovectomies and had both achilles tendons operated on. Get roaming tendonitis all over my body day after day. My elbows are locked into very limited ROM and covered with spurs. Shrug. I call myself "mystery meat."

Although the least radiation exposure the better, exposing the extremities (hands and feet) are the least problematic with continued, repeat exposure. Vital organs and head/neck are more concerning for additive exposure. Tracking disease progression on hand X-rays once every year it two really doesn’t pose that large of a threat.


In the Uk the protocol is still for x-rays initially then MRIs if indicated, not sure what the protocols are for other countries


Marie said:

New here but as a healthcare professional I am wondering why fellow PsA sufferers are getting all these Xrays?

It seems to me we should be requesting ultrasounds or MRIs instead to avoid the buildup of radiation in our bodies.

I have read and been told by my Dermatologist that there is a specialized ultrasound for just this purpose.

After being exposed to multiple Xrays with NO DX for my hip condition I finally was Xrayed standing up rather than

lying down . There it was clearly visible bone on bone and loss of catilage. xrays do NOT show cartilage as I understand it .Evidence is obtained from the bone on bone positioning clearly seen in the testing. Frankly , I am annoyed that I have been given so many useless Xrays in the past.