MRI scan in psoriatic arthritis diagnosis

Posted Mon 16 Nov 2020 11.13pm by Katherine


I am posting because I am really confused about what is going on and wanted help from the experts, which from my experience of epilepsy, is often the people who suffer from it (though I know none of us can offer true medical advice).

Sorry if this is long but I just wanted to give the whole context. I developed upper back pain in 2014 and in 2016 I developed terrible pain in my lower back, coccyx and thighs. A scan revealed that I had a disc protrusion in my lower spine and a flat back. I had a few flare ups and my life was impacted but the pain fluctuated rather than being constant.

Fast forward to the summer of 2018 and a lot of heavy walking in Paris on holiday, and I developed sharp pains in both my hips/thighs which later also led to dull pain and soreness. I was told it was bursitis and it would disappear in two weeks -it didn't. Had an MRI in Feb 2019 which showed inflammation in the tendons - I was told it was Tendinopathy and it would go away. Fast forward to 2020 and it hadn't gone (though it had improved). I also had developed bad pain in my coccyx (more in the context of sitting for too long) which I at first put down to my disc but it was atypical in relation to how it had been previously (only tended to get the occasional sharp pain since 2016). Saw another rheumo in 2020 and he advised that he thought it was psoriatic arthritis and that the coccyx pain was maybe part of it.

Now getting to the main point of the post - I had an MRI on the coccyx, spine and sacroiliac joints and it showed nothing atypical beyond the already identified issues with my spine. I suppose, what I wanted to ask, is how critical is an MRI to diagnosis of psoriatic arthritis? I am starting to wonder if I have been misdiagnosed. As regards the pain in my hips/thighs now - I get the occasional sharp pains and soreness and the area is still tender to the touch. But the MRI being clear has thrown everything up in the air for me. And what is more worrying is if the diagnosis is wrong, I am concerned as to what is causing the coccyx pain, and if it is the disc that could make things difficult. Really would like to know others experiences of diagnosis.

Thanks in advance!

Posted Tue 17 Nov 2020 3.48pm by Northernelf

Have you read about Axial Spondylitis ? Psoriatic arthritis is under the Spondylitis umbrella, along with ankylosing spondylitis, reactive arthritis, and such. There has been more & more research about women presenting somewhat differently than men. Specifically, look up non radiographic axial spondylitis. Not a doctor but it is something I've been researching - I have similar symptoms and more.

Good luck.

Posted Sat 21 Nov 2020 10.17am by Mac

Hi Katherine.

The MRI,

Well it's good that it didn't show any thing new, as in no more damage, bad for you trying too get things sorted. I'd take the first any day of the week. MRI isn't critical but definitely helps as you know. A physical examination is more important in diagnosing things, from what i've found.

Good luck.

Posted Sun 22 Nov 2020 3.35pm by Katherine


Thanks for your replies.

I know it's good that the MRI didn't spot anything but I suppose it doesn't change the fact that I feel this pain (which has extended to the right shoulder and neck) and feel more lost than ever about what is causing it. I am seeing my rheumo in January (though properly just over the phone!) and I will have a frank discussion with him then.

Thanks again

Posted Sun 22 Nov 2020 4.23pm by Mac

I honestly wouldn't worry about the MRI not showing any thing. I'd doubt it will be a phone consultation, i would say they'll bring you in for a physical examination. If my experiences are anything to go by, if there's a problem they'll find it. When i have my examination they never miss once, and if it's not sore when i go in, it sure is when i'm on my way out.

Good luck.

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