Sacroiliac arthritis

[mohair3]

Hi,

It all started with severe lower back pain after being hospitalized for Pelvic
Inflammatory Disease/salpingitis/cervicitis/cystitis.  Within a few weeks of that hospitalization, I had knee pain so bad that I couldn't put weight on it but it was not swollen.  It cleared up.  I next started having eye problems and was diagnosed with nothing, then blepharitis, dry eyes, conjunctivitis and now I have recurrent episodes of episcleritis and corneal tears. I was misdx'd with lupus at one time, but my ANA was always negative.  I finally got a Rheumatologist to xray my sacroiliac joints and his opinion in looking at the xrays was that I either had Reactive Arthritis or Inflammatory Bowel Disease (colitis).  I had a colonoscopy and everything was normal except for a small polyp which was removed.  After many, many years I now have decreased range of motion of my spine, and loss of lumbar lordosis, and one doctor suggested that I have the beginnings of spondylitis from  a chronic reactive arthritis.

I have no diarrhea.  I do have episodic IBS (constipation type)but it is controlled with vitamins and avoiding a lot of chocolate.  The IBS is a recent event and the sacroiliac arthritis was first seen in 1989 on CT scan.

My question is what should the doctor be doing to positively diagnose which disease I actually have?   Isn't what he has done already enough to diagnose?  Based on what I have told you, which diagnosis would be most likely?

Thank you so much!
Cheryl

[calicotv]

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[Glasscrafter]

Go to the Spondylitis Association of America's website and check out the symptoms of reactive arthritis and ankylosing spondylitis. You do not have to have a positive HLA-B27 test to have AS. You should have an MRI done of the SI joints as that is one of the definitive criteria for AS and Reactive Arthritis. Their forum is a wealth of information. I also have AS and ulcerative colitis.

[mohair3]

I paid $15.00 to have a question answered.  He went all around the question.
It was a waste of MY $15.00.  It is a scam.  And he doesn't make enough money off of people here, so he does it on his other web site.  I knew he couldn't diagnose, but he didn't answer the question either.

[DanTheGojiMan]

It worked, she said she could not belive it and so she stoped taking it to tested out and the arthritis pain came back after a week,  She told me that she'll never go with out it now.  She doesn't take pills for her pain any more only drinks the require dosege.  Just try it.  you can order it at

  www.specops.freelife.com

We tend to think of arthritis as an "old age" disease. Perhaps that's because the most common form of arthritis

[andi04]

If you want answers you should always go to your doctor, that is what they are there for, this is just his opinion he is not your doctor therefore he can not diagnose your problem without seeing you in person.  In my opinion he gave you a good answer, bite my head off try me I dare you....

[mohair3]

Oops.  I forgot about the MRI of the spine.  It did NOT include the sacroiliac joints though. They scanned the cervical, lumbar and thoracic spine without contrast.
It says:
Mild degenerative end-plate changes.
L5-S1 herniated disk extrusion minimally effecting the thecal sac.
Facet joint hypertrophy is seen in the lower lumbar spine without significant stenosis.


ANA has been repeated several times over several years.

Wouldn't the cervicitis/salpingitis infection and the acute knee arthalgia within weeks of the initial infection, indicate that it was a reactive arthritis more so than an inflammatory bowel disease?  

The order of events was:
Cervicitis
Hemorrhagic Cystitis
Salpingitis/PID
Acute knee Pain
Lower back pain and eye pain

I can not figure out how the inflammatory bowel disease could even be considered at this point.  How would an MRI rule out the IBD????????

Thanks

[Kevin Pho, MD]

I agree with the testing that has already been done.  Further evaluation of the spine can be done with an MRI of the affected area.

You could also consider blood test like an HLA B-27 level to rule out rheumatologic diseases like ankylosing spondylitis.  Repeating the ANA and rheumatoid factor levels can be considered as well.  

A referral to an orthopedist can be considered to further look at the spine, as well as a consultation with a physiatrist to investigate rehabilitation potential.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_