PSA Sacroiliac question

Hello all. I have been lurking for sometime. The information and support on this sight is great! Thanks to all for your questions and great answers and support. I was diagnosed in April of this year after finally switching GPs who listen to me (my former GP told me I was just getting old/or it was all in my head) and referred me to a Rheumatologist. I have PSA in my hands, wrist, elbows, knees and feet. Fortunate that the damage is not advanced and am taking Methotrexate to try and keep it that way.

My question is surrounding my back. The rheumy did an MRI using spondylarthrophay protocol to determine if there was any inflammation in my neck and lower spine. The results indicated there was no inflammation but bilateral spondylolysis at L5 and C4 and C5. Over the past several couple of months my neck and lower back pain and stiffness has increased significantly. Given the MRI did not show inflammation but did show arthritis does this mean that the psoriatic arthritis will never impact my spine? The rheumy did tell me that if there was spinal the methotraxate would not help and Enbrel would be the treatment. Just curious on how I should proceed. Hope this make sense.

Your comments are really appreciated.

I do not think that one can determine PsA will never affect your spine based on one MRI but I could be wrong. It is probably a question best answered by your Rheumy. My understanding of MRIs is that can't really show PsA but can show damage afterwards. And of course by then it is too late. My Rheumy diagnosed me with spinal and right sided PsA based on damage all ready done on MRI and stiffness in my hands, feet, knees and spine in the morning or anytime I sit. Mt stiffness and pain and swelling are predominant on my right and spine but as soon as I say that someting on the left swells so who knows for sure!

Michael in Vermont! it’s sounds like my disease is taking a pretty close route to yours (I say close because for 1 I don’t really know and 2 this disease seems to be unique for everyone). My right side bothers me a lot more than my left, but as soon as I mention that my left aches.
Gardener, I wish I had a good answer for you, but alas I’m just new to this disease and learning about everything. I already have damage tommy is joints and l5/SI. It is definitely not fun!
Would your doctor be willing to switch you to enbrel? Would it work for your other joints affected? If it is an option you both would consider, I would look into it. These medicines are made to prevent damage and one that won’t prevent all of it to me isn’t worth as much as one that would.
SI damage pain is a literal pain in the butt!.. And back and hips…