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I haven't got clear answers from my rheumatologist and I am a bit confused so your interpretations could help me a lot. In your opinion, am I suffering from mechanical back problems and / not possible early symptoms of AS?
Background: I was diagnosed with polyarticular JIA (seronegative) at the age of 12, treated with methotrexate and biological drug (remicade), prednisone. My condition improved significantly and for years I have been almost completely symptom free. I am HLA-B27 positive with the family history of AS.
This year however, at the age of 23, I have been experiencing neck pain and stifness, swollen index finger and overall aching and feeling 'pressure' on hand/fingers, sharp pain between shoulder blades, dull aching on low back/buttock on left side which radiates to my knee. I am not experiencing morning stifness and the aching seems to be constant regardless if I am moving or not. However, especially during the nights I am having difficulties of finding comfortable position to sleep. My blood tests have constantly come back reassuringly normal, chest x-ray normal.
However, MRI of whole spine shows congenital inter-body ankylosis at c5/c6. Slight anterior tilting of the body of c4 and c5 and widening of the interspinous distance at c4/c5 suggesting possible instability. Fatty signal changes are present in the pedicles and pars and hyper-intense lines run transversely across the pars at L5 suggesting a chronic spondylolysis, there might be minimal spondylolisthesis.
MRI of the sacroiliac joint shows no evidence of active spondylitis. There are areas of fatty signal on the lateral aspects of both sacroiliac joints and the medial aspect of the left sacroiliac joint, may be the result of previous sacroiliitis.
I have started the methotrexte treatment again and also I have been referred to orthopaedic spinal clinic as clearly I have some mechanical issues. However, I have not given clear explanations about the appearances of the sacroiliac joints and whether it might be early AS ( I was only told that it is not active). I am getting a bit frustrated as I am not getting clear answers.
I would appreaciate any input that might make things clearer for me.
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