RA - Spinal Vertabrae Activity? | Arthritis Information
I’ve was diagnosed with Sero-Positive RA in December/06. Up until fairly recently my RA has been fairly well controlled with MTX, Plaquenil and occasional Predinosone. However, towards the end of September/09 I began having major back issues with my RA flares. After even a short period of inactivity my back stiffens up and I’m in major pain to bend both forwards and backwards. For the past 10 weeks or so it has been a major ordeal to perform simple tasks such as bending down to flush the toilet or picking up my shoes as well as getting out of bed and in and out of chairs. My Rheumy has called me in Medrol packs twice during the past 4 weeks and both times the Medrol did wonders for me and I felt great. However, as the Medrol packs wore off after finishing them my pain and stiffness has returned. In an effort to determine if this was indeed RA related I made an appointment with a Chiropractor who performed some back x-rays. The x-rays showed no obvious fractures, etc.,. However they did show that I have a vertebrae that is in the process of “fusing” to my pelvis with one side of my vertebrae being almost completely fused to my pelvis. The fusion is causing major side to side curving of my spine. Since finding this out, I’ve made an appointment with my Rheumatologist for the first week in January to ask him if he believes this is RA related or a totally separate issue.
Have any of you RA’ers experienced this or heard of this “spinal fusing” issue with RA activity? Any info would be greatly appreciated.
Check out Ankylosing Spondylitis.ditto what Sam said....AS can present like RA
Thanks for the advice. I've wondered this myself. Can AS make you go from Sero-Negative to Sero-Positive on blood labs?
I'm so sorry you're going through this. I hope you get a definitive answer ASAP and get put on the right meds. Best wishes.the rheumatoid factor can be positive in any number of rheumatological diseases..it can also be positive in people with no signs of arthritis. Its an indicator test not a definitive oneYou may have multiple arthritic diseases, as I do. In other words, you may have RA [sero-positive] and Ankylosing Spondylitis [sero-negative] concurrently.
Thank you for the suggestions. You know it's funny (not really) . I had started having major back problems (1) year before I was diagnosed with RA by my Rheumatologist. About (5) years ago I had been visiting a Chiropractor for these back issues and at that time she performed a complete set of back x-rays. Last night I was going back through my notes from these chiro visits and saw that she had asked me back then if I had ever heard of "Spondalytis" (not Anklosing Spondalytis") and whether or not I had ever been told that I have this condition. She didn't explain what this condition was nor did she actually come out and say that I did have it. She simply asked if I had ever heard of the condition. However, my notes show that at that time she did point out that the x-ray showed that the lowest vertabrae closest to my pelvis was beginning to fuse and said that she had no way of knowing how long I had actually had this partial fusion, which I realize now was probably the reason for asking me whether or not I had heard of Spondalytis. According to my notes she had told me at that time that it may be nothing to worry about but that I may want to keep an eye out for future back issues and she left it at that. At that time, I hadn't yet been diagnosed with RA or experienced the meriad number of other issues that go with my RA such as major fatigue, hand, wrist, knee swelling, etc.,. That said, I didn't think too much into it and pretty much forgot about it. Now that I've dug up these notes and think back on that visit I'm really wondering if this Spondalytis that is causing my back problems. I called my Rheumatologist this morning and told them about my recent Chiro visit and also to ask the nurse some questions and she called me back and said that my Rheumy wanted to schedule an appointment to discuss this. The wierd thing though is that my Rheumy had just sent me for back x-rays (2) months ago. He did not receive copies of the actual x-rays however, he did receive a report from the radiologist stating that there were no sublaxations, fractures or anything else "extrodinary" about my back.
I wonder why the radiioligist didn't mention this "fusing" on my lower vertabrae or the fact that my spine was "snaking" from right to left due to this "fusion"? I will definitely be addressing this with my Rheumatolist................
I guess the good news is that if I do have AS, the condition is treated with the same meds. However, the bad news is that my current meds aren't cutting it anymore. I doubt my Rheumy will want to increase my MTX dosage as the medication already has my liver enzymes climbing and out of whack which I'm currently having to perform blood labs every (6) weeks to monitor. Due to my elevated liver enzymes I may need to switch to an alternate med.
Which brings me to my next question, is Enbrel hard on your liver like MTX is?
Ta2d2009-12-15 07:47:05Ta2d,
It is curious that the more recent x-rays didn't pick up the fusing. But then, it depends on what the physician wanted to focus on....could be that the area of fusing wasn't the central focus and the angle of the x-rays obliterated the fused area. Perhaps there's someone on this forum who knows something about radiology who can explain this.
I can't speak to the issue of Enbrel and liver toxicity. But it appears that Enbrel is less toxic to the liver than MTX. [Am I correct in that the amount of MTX is minimal when used in conjunction with Enbrel???]
I did happen to find a good coprehensive link to info on various treatments.
Another website:
It will be interesting to hear from those who have taken both Enbrel and MTX and who have tracked their liver function tests.
[QUOTE=Sam1234]Ta2d,
It is curious that the more recent x-rays didn't pick up the fusing. But then, it depends on what the physician wanted to focus on....could be that the area of fusing wasn't the central focus and the angle of the x-rays obliterated the fused area. Perhaps there's someone on this forum who knows something about radiology who can explain this.
[/QUOTE]
Sam,
That's exactly what I can't figure out. I can say that the Chiro took many more x-ray views as opposed to the radiologist at the hospital who only took (2) (one from the front and one from the side). Gauging by the crosshairs on the x-ray that the radiologist at the hospital took the focust was mid-back. Whereas, the fusing that was shown to me on the earlier x-rays were at the lower back where the lowest vertabrae is closest to the pelvis which was causing abnormal curving of my spine. I plan to call my previous chiro to see if it's possible to get a copy of those earlier x-rays to take to my rheumy. Not sure how open to providing me with these x-rays they will be though (even though they are mine).
you have by law complete access to all your xrays. X'rays can tell you a lot but they are subject to interpertation...a radiologist very well may not see clinical significence where a chiropracter may.
The spondylitis family of arthritis differ from RA in that they must have spinal involvement ( ra is generally limited to the very upper cervical spine and SI joints) and they tend to have more soft tissue-tendons- involvement. But the diseases are usually treated the same way. My knowledge of Ankylosing Spondylitis is that it has to do with any of the joints in the spine or immediately connected to the spine [e.g., hips]. I have read that some physicians believe that AK can also extend to knees, elbows, etc.
What that tells me is that we really know so little about arthritic and autoimmine diseases.
[QUOTE=Ta2d]
Which brings me to my next question, is Enbrel hard on your liver like MTX is?
[/QUOTE]
No, it is not. And while Enbrel was working for me (seven wonderful years) I had much less back pain, even though to my knowledge I do not have AS, too.
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