MRI scan in psoriatic arthritis diagnosis

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.

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.

Hi, 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

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.

Hi Katherine I too have had a recent PA diagnosis. This follows years of having had flare-ups of lower back pain and ending in having an MRI scan showing disc protrusion in my lower spine - however at this stage PA was not diagnosed. Also get pain in knees, but put this down to being a cyclist and jogger. Since Feb 2020 I have developed severe problems with my shoulder and very restricted movement in my arm - I thought this was swimmers shoulder as I swim long distances (well I was previous to shoulder problem- now unable to swim at all :( ). I was surprised when my GP referred me for an MRI and a referral to a Consultant Rheumatologist. Anyway, the outcome after an MRI scan and a couple of very small lesions on my inner wrist the consultant diagnosed PA. Not what I was expecting. I have a follow-up appointment next week 4/2/2021. So watch this space.

Does anyone know if there is a blood test for psoriac arthritis,or how it is diagnosed ?

Good luck Sandy. I had a phone consultation earlier this month but trying to communicate over the phone was difficult, so he's going to organise a face to face appointment. Hopefully we'll be in a better place covid wise then. June - there is no definitive test for psoriatic arthritis unfortunately, hence why in my post I mentioned I am unsure about my diagnosis because it is always a clinical one. However, doctors can rule out other things through tests (such as the closely associated Rheumatoid arthritis) and use scans (such as MRI scans) to support a diagnosis or potentially upturn it I suppose. At the end of the day there is no golden bullet test and it will rest on the clinical judgment of the doctor, using all the evidence available to them (including a physical examination and medical history), to make a diagnosis. That's why it can be difficult to diagnose. I hope things are OK with you and if you need any support, you can post on here and I am sure others will be able to offer you guidance and advice.

Hi there - this really highlights the hit and miss of diagnosis. I was really lucky to have been sent very early on for a Doppler ultrasound on my wrists which showed inflammation. at the time I didn't have any issues with my wrists and thought I was going to have my neck scanned - it had already been MRId and I thought this was just a different way of looking. Anyway, feeling like a bit of a fraud I went away and thought nothing of it until I got a letter months later telling me I had to come in urgently to rheumatology as inflammation had been see. So I went to the appointment, asked about blood test and was told in no uncertain terms that they were now irrelevant as the inflammation had been 'seen' and in any case a large percentage (40% ?) of patients do not have detectable inflammation markers. This sometimes means it could be 'sero negative rheumatoid arthritis or another type of inflammatory arthritis such as PsA which doesn't have the same markers. I too have horrendous pain in neck and upper back and at the other end in sacroiliac joint and coccyx, but since diagnosis have developed symptoms that are typically rheumatoid. feet, knees, elbow (oh God the elbows) . the main issue though is that the treatment for all these autoimmune conditions is typically the same initially. My diagnosis was Undifferentiated Inflammatory Arthritis and I was given hydroxychloroquine which did nothing and after a few months methotrexate was also added and after 4 months that's not doing anything either. The thing about scans is that it is possible that there might not be any inflammation to see on that particular day. Blood tests are cheaper and easier to carry out but I really think that the scans should be more available as it seems to be the best way to get a definitive diagnosis. The MRI on my neck as the time showed no inflammation but that doesn't mean it wasn't there. My neck and upper back are so bad that I have been referred for another one but not as a priority. all they will be looking for is damage, inflamed or otherwise becasue if there is inflammatory arthritis in my spine then I am already on the medication used to treat it. My biggest complaint about the whole process is the lack of physio therapy. It really does help but I have to cobble it together from Youtube videos whereas being seen face to face for some guidance on how to do exercises properly would be such a help. My GP said NHS was target driven and didn't give a toss about self help and prevention. Great.

I was told by a rheumatoid nurse, unlike arthritis, PA is extremely difficult to diagnose via a MRI. This is due to the levels of flare ups. RA (Rheumatoid arthritis) tends to show up on a MRI when there is no flare up, and yet PA you must be having a episode for it to be detected on a MRI. However, there is a genetic blood test that can be done to see if you do in fact carry the PA gene. Once that is detected they can then, start to treat you as though you have PA. I also forgot to mention, for years I complained about my back pain. I was always fobbed off. In 2015, I finally got my MRI and it turns out I have a bulging disk in my L5/S1 area in my spine, and while its not compressing any nerves it irritates my S1 nerve, resulting in sciatica episodes. It also showed that I also have the on set of degenerative disease in my facets joints. All this was found on my MRI scan, yet they were suppose to be checking out for PA???

Hi Lindz, Many thanks for your message - that was really helpful. I will ask my rheumo in regards to the genetic test as I have heard nothing about that. Yes, I have something along the lines of a bulging disc which my pain management s believed was the direct cause of my lower back pain and at least some of my coccyx pain. However my rheumo seemed to think less of it than my pain management specialist so who knows?! I am sorry to hear about your degenerative disease - it all seems to happen! I know others who have it and have a reasonably good quality of life - I hope the same could be said of yourself. I am sorry to hear of your experiences Mausie. Have you not been able to access to face to face physio? I am currently having hands on physio for my shoulder area. I know it is tight on the NHS, especially during these trying times. I hope they manage to find some sort of treatment that helps you with the pain.