Results - Liam and Jane. | Arthritis Information

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HI Guys, well it was la long day and not a very nice end to it unfortunately.

 
Liam was ok, his dad took him to see the assessment team that will be working with him while he is in hospital.  There was a paediatric RD, Physio, and neurologist.  There will be more when he is an inpatient.  He is basically still in much pain but he is off of MTX, down to 5mg of  pred reducing to 0.  He is not allowed to take too much Tramadol, mainly panadol and the Drs said we are not to expect too much too soon, but RD's theory is that his pain will improve when his life is back to a normal routine.  I am happy to go along with this as I don't know what else to do, but I still believe Liam has AS and JIA as does my RD and GP.  I guess while an inpatient they can moniter him and see what is going on.
 
Then it came to me, I am claustrophobic so I had sedation, they did MRI of lumbar and cervical spine, and an X-ray of my feet..
 
The report took them ages to type so I knew it wasn't going to be good news.
 
To cut a long story short, my spine is really awful.  I am seeing my RD on Monday and will decide with him what is the best plan of action.  Here is a little of the report.
 
Osteophytosis at C6/7, further changes also present at C7/D1 particularly with postero-lateral uncovertebral osteophytes.There appears to be a moderate foraminal stenosis on the left and impingement of the left C8 root.
 
There is a loss of normal lordosis with retrolisthesis of L4 upon L5 and grade 1 anterior listhesis of L5 on S1. Bilateral pars defects of L5.
 
At L2/3 there is a central left diffuse annular bulge and flattening of the theca.  Moderate facet changes are present.
 
At L3/4 there is loss of normal water signal from the disc.  There is a right paracentral disc bulge.  The disc does lie close to the right L4 nerve roots as they emerge from the theca.
 
At L4/5, loss of disc space height, mixed modic 1 and 11 change is present within the endplates.  There is a central left diffuse disc annular bulge.  The right and left L5 nerve root are intimately related with the disc as it coursed towards the lateral recess.
There is some far lateral extension of disc that lies adjacent to the ventral ramus of the right L4 root.   Decompression is noted. 
 
At L5/S1, loss of normal water signal from the disc.  There is anteriolisthesis.  Intense sclerosis is present.  Bilateral pars defects.  The disc is intimately related to the left L5 nerve root, within the lateral recess.  Marked degenerative change noted within the facets.  Impingement of the left L5 nerve root within the lateral recess.  Proximal right L5 nerve root  is indistinct and impingement cannot be excluded.
 
Degenerative disc disease most marked at L4/5.  Anteriolisthesis of L5 upon S1 due to bilateral pars-interarticularis defects left greater than the right with intense sclerosis present at both these and the degenerative facets.
 
Sorry that was so long but the actual report is much longer still, so I don't know what Rd will recommend.
 
The feet are now showing erosions within the left midfoot, particularly the anterior process of the calcaneus and navicular and cuboid.   There is some cortical thickening over the proximal shafts of the third and fourth metatarsals that is in keeping with healing fractures.
 
 
The right foot shows erosive changes also within the cuboid and the navicular, there is a healing stress fracture of the proximal third and fourth metatarsal there is a large plantar spur, Ultrasound could possibly show the soft tissue changes associated with plantar fasciitis.
 
I am very upset about these reports and really am worried about spinal surgery which my Drs have already said is quite probable.  I am shocked about erosive changes as less than a year ago there were none.  However I knew something was going on with my feet, they have definitely worsenend with pain. 
 
I would appreciate your input guys, thankyou in advance.  I am trying to get my head around it.  Does anyone know what the D1 disc is?
 
Regards JaNE.  
I  don't know what you want to know about the D-1 disc, Janie
I found that it is the intervertibral disc between the 12th thoracic vertabra and the first lumbar.
 
I have a small portion of the back issues you do and I can only imagine the discomfort... as for feet!!  we need them!!  and the pain in them is truly a bad thing... what can be done?  Ifind the majority of my discomfort in my feet now.  I guess because I must use them all day.
 
Liam..... what a strong young man...  he has alot ahead of him.. I know you and your DH will support him through all this.. He too, along w you, are in my thoughts and prayers

Oh Janie - I'm sorry the news was not good for you and pretty inconclusive for Liam.

Please try to keep hope in your heart.  I've seen even the worst things turn around and go well. I'll keep you all in my prayers.

I hope your rheumy has a plan of action.  Its hard to know where to begin
good luck
Thanks guys, does anyone know if you are allowed to keep walking if your feet are eroding, mind you the pain has been so intense that I haven't been able to walk.  Hugs Janie.
I reckon my spine needs a good clean up, there are bits of disc everywhere there shouldn't be, maybe if they removed them they would free the nerves Up????Best wishes for a speedy resolution for both you and your son. Janie,
Sorry the report wasn't so good.  Hang in there and I hope for relief for both you and Liam.
Phats
 

the doctors wil want you to walk as long as you can.  The question will be is if there is something that can be done surgically to stabalize them

Janie,
I am so sad about your news.  This is going to be a hard time for both you and Liam and my prayers are with you both.  Please stay in touch.
 
Pat
Janie, My thoughts are with you and Liam.  I hope there are answers for both of you.  LindyWOW! That is a lot to take in. I am sure your RD will have answers and a plan of action, at least I hope.
 
Please let us know what your RD says about all of the MRI reports and on how Liam is doing and coming along.
 
Much hugs & prayers for the both you!
Janie,  I don't even understand all of that but am so sorry to hear your reports. My feet have some of what you have, but not nearly as much, so with all my pain, I can only imagine yours! No advice except, walk some, use your aides when out. Hugs. Just want to say good luck.
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