I would love to know a little bit more about the imaging people with PsA are having. Have you had any x-rays or scans? Loads or few?
Was it super frustrating to get any answers about what was seen on the scans? Or was it more of a relief to finally be able to tangibly see and identify what is causing you so much pain?
During the past two years I have been in and out of MRI scanners, had a few x-rays, SPECT-CT, and lots of ultrasound. Sometimes I’ve felt really included and have had the results shown and explained to me, and other times I haven’t had a clue. What has it been like for you?
Hi have had a variety of xrays. A complete bone scan. CAT scan of my spine. Drs will discuss with me but only because I insisted. The xray of my right leg & foot only happened cos I sat in my docs office & told him I refused to leave until he wrote the order (I'd had a bad feeling about R leg & foot for a while but he felt it was ache s& pains - well DUH Doc I do have PSA) The xray confirmed what I had been suspecting- definite joint changes & damage
I had some x-rays, but that's it at this point. I'll be talking with my rheumy about getting an MRI of my neck, as I've had ER docs recommend it with my current issues. Basically, my rheumy and I were in agreement that until we could find something that works for me to treat my PsA, I really didn't want to be completely aware of the extent of the damage. The x-rays of my ankles, SI joints and hands showed damage in 3 month increments, so knowing that just about every other joint in my body could be damaged at the same astounding rate is enough without seeing it for myself. LOL
I think my rheumy's thought is that scans aren't necessary unless there is action that needs to be taken. Right now, I'm ready to get x-rays of my thumb, but I'm 99% positive that that particular problem is osteo, and I'm ready for a cortisone shot there. Everything else seems to be just slowly progressing, and we go based on pain and inflammation in terms of treatment decisions. I'll point out that my blood work doesn't show much of anything.
I actually just yesterday had an MRI of my right hand to see if any damage has developed. It's been a little over a year since diagnosis so it'll be a good marker I think :). I have has scans in other areas, but the damage that exists in those other areas can be attributed to other things (though i'm suspicious and will bring it up with my rheumy). I did have to press to get an MRI, it seems like as long as my blood tests are within normal range he doesn't really see the need to change (or do) anything.
My first rheumy used his ultrasound machine to look at the tendon in my feet as well as my thumb joints. He have me 2 cortisone shots under the guidance of ultrasound. He charged the insurance company hundreds of dollars, and the shots weren't effective. He resisted prescribing a biologic med, I think, because I had more joints that could have been injected, providing more income to him. I think ultrasound can be great, but MRI and cat scan are the better instruments.
Laura E D said:
Thanks for sharing! At the moment I am thinking a lot about how imaging could be used to see how well our drugs are working and whether a treatment is sufficiently effective in reducing disease activity, joint and tendon damage. Ultrasound is great, but it takes a lot of time and skill to learn how to do it well. Are any of your Rheumatologists using ultrasound in their clinics?
I had some initial xrays done by an orthopedist checking on joints before being sent to my rheumy. The effected joints are still swollen. At my last visit a couple weeks ago we talked about the look of the joints and the subject of xrays was brought up to see if they had suffered any damage. I decided that since I was more interested in function and everything was functioning well that I didn't need to see the damage. It wasn't going to change my course of treatment right now so we decided that they weren't really needed.