Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group SAA - Doctors Q & A Session

Alinus - glad you found it as interestng as I did. Agreed, think this should be a real 'heads up' for admin. There is some crucial informatioon here, in spite of the fact that part of it *does need updating. But that aside, crucial information for ASers - new and old timers. (So easy to forget so many of the facts of the matter - too much info to take on board sometimes!)

Go well.

In this instance Molly and Alinus, to be good 'netizens' we should be respectful that the information does not belong to us. Although the SAA does allow and encourage sharing this information (by various means such as Facebook etc), people are guided to share in the form of a link, rather than copying text. There is a copyrights line at the bottom of the page. "© 2009 Spondylitis Association of America, All Rights Reserved" that should be respected.

Ideally, whenever we want to 'share' info on KickAS that is owned by another site, a short copied excerpt accompanied by a link to the full article or page is the best method. (See the R&R's .) It is easy enough for members to click a link and no need to infringe on copyrights.

Discussing any of the information here is fine, of course!

Have posted links time and time again Mig - and no comment come back (hardly). Yes, have recently posted SAA link. Somehow don't think people bother, or don't search out the link for the info.

That was why I posted it the text. Otherwise, would have odne as I 'usually' do, just post the link with a very 'brief' overview - especially when it is SAA; NASS; LDN etc.

If by comments you mean the number of replies you receive to any given post Molly - sometimes that might reflect a lack of interest in a particular subject, and yes, sometimes it may simply be that some people would just rather not bother making the jump to follow a link. Unfortunately, that's life! Regardless, we still need to be good netizens. (citizens of the net!) A brief overview or snippet really is the best practice, as you usually do.

You can lead a horse to water... yes?

Content in two post removed. Upto KAers to look out the content on the SAA website, have left the link so that they can do just that - mebbe with appetite 'whetted' by few brief comments collected/garnered along the way, they will check out the source. Hope so! 'Smile'.

I hope so too! Thank you Molly!

This is where I get confused as my X-ray showed signs of SI damage but when I then went for an MRI - it came up clear?? How does that happen??

Was it plain X-Ray or CT scan Tarnip? Otherwise could be very low tesslar MRI? Am n ot a radiographer, nor doctor.

But, as far as I am aware, for MRI, would need to be Saggital STIR tau 1 & tau 2, fat supression. That will show up SI problems. But as you have SI damage and it is showing on plain X-Ray, then you have SI damage.

Wouldn't worry if I were you - but put question to a radiologist. Might 'even' be able to google it or, put question to a radiologist's link?

Good question. So, should you find the answer, then do let us know - would be of interest to know.

i was wondering similarly as my CT scan showed signs of SI damage but the MRI was better than that as well. from my reading, said the CT was better at seeing "bone", "bone changes, boney changes" and MRI better at seeing soft tissue, like inflammation. when i had the MRI, i had already had a cortisone injection the year previously, then about 6 months later followed by continual wearing of the flector patch for about 8 months to the point that i had almost no inflammation when i went for the MRI, so was more interested in the permanent changes. for me this means i have changes, just still at the mild stage so picked up by CT but not MRI as much. i had thought MRI was more sensitive overall, but turns out, not true, more sensitive for soft tissue / inflammation, but CT more sensitive for bone.

maybe the same is true of xray vs MRI?

also, did you have the STIR imaging? sorry, i do remember you discussing this result in the past, but can't remember if you had STIR imaging.

and were you on antiinflammatories that were controlling your symptoms at the time of the MRI like i was?

i have found it interesting to note that they suggested using the MRI to monitor treatment plan effectiveness.

for me it would have been nice if i had had images before treatments, but in the case of the nuclear bone scan, was approved for that finally only after things were bad enough to finally get cortisone injections bilaterally under fluoroscopy the previous month which of course quieted everything down. and then the MRI finally only after finally getting on the flector patches.

if i could cover my body in flector patches i'd be happy with this treatment plan, but 1) just because the SI is now mostly under control doesn't mean the rest of my body is and 2) the flector patches even have been no match for a good flare, SI joint was a mess in august, then took september and october to quiet down again, would have liked the MRI during the flare, but by the time i could get it, things had quieted again. and i won't just let myself go to get test results, i have to work, have to stay functional, so will do what i can to achieve that, and if that skews any testing, so be it. nice to have a doctor that has a similar philosophy. we're just both glad the flector patches work so much of the time, but looking for something to treat the whole body systemically and something that works to maybe even prevent flares, that would be nice.

what about you? when did you have an MRI? during a lull period or during a flare? during treatment or prior?

Hi Tarnip,

You are right that your results are confusing.

I am not really sure on this (so take this with a grain of salt), but I believe that bony-changes will show up better on standard xray, whereas soft tissue damage and the inflammation of sacroiliitis will show up better on MR imaging. If your inflammation was down in the period you had the MRI... then perhaps that's a possible reason?

Otherwise, maybe it reflects the difference in 2 radiologists individual opinions. I just had a new set of xrays taken as a follow-up to one's I had done in 2006, so about 4 yrs apart. In 2010 the xray report made no mention of fusion in my cervical spine, but the xray reports from 2006 said I had ankylosis on the back of C2 to C4 with narrowing facet joints in my neck. So I had to ask my rheumy, "It's not possible that the fusion could have magically disappeared, is it? And he said, no, sorry... and explained that it was probably just a difference between the 2 radiologists. At least I feel fairly confident that there hasn't been any notable progression over the last 4 yrs.

It may be useful to ask for a nuclear bone scan? It may show hot spots of inflammation that would give your doctors more information possibly? Just a thought. If you have SI damage on xray, then depending on the grade, that can be pretty solid evidence when viewed along with clinical signs and symptoms. AS can be a difficult diagnosis, there's no doubt about it.

Hope this helps a little,
mig