Normal MRI. Ankylosing spondylitis symptoms ?

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Had an intense back ache with pain for just under three months. It started off as a general ache and then got worse and spread to the middle of my back. It also travels down my buttocks (normally one side). I also get pain in my knees that is horrible in the morning and heel pain that hurts to walk on and is again worse in the morning. I sometimes get pain around my hips. I am currently taking tramadol which helps. The pain is worse in the morning and improves with light excerise. I also find myself waking up most nights because my back and knees are sore and my back feels stiff. I had an MRI after my specialist nurse ( who I see for my Crohn's disease ) thought that I might have Ankylosing spondylitis. My MRI has come back normal and the drs have told me that they think my it is muscular. Bit confused now. Not sure how muscular back pain would cause joint pain in my knees

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  • Posted

    Hi Victoria,

    What you describe may be a form of Enthesitis (inflammation of the entheses, the sites where tendons or ligaments insert into the bone) and is sometimes associated with HLA B27 arthropathies like ankylosing spondylitis, psoriatic arthritis, and reactive arthritis (Reiter's syndrome). Symptoms include multiple points of tenderness at the heel, tibial tuberosity, iliac crest, and other tendon insertion sites (From Wikipedia).

    The Spondylitis Association of America at http://www.spondylitis.org has a good page describing the possible symptoms.

    "In a minority of individuals, the pain does not start in the lower back, but in a peripheral joint such as the hip, ankle, elbow, knee, heel or shoulder. This pain is commonly caused by enthesitis, which is the inflammation of the site where a ligament or tendon attaches to bone. Inflammation and pain in peripheral joints is more common in juveniles with AS. This can be confusing since, without the immediate presence of back pain, AS may look like some other form of arthritis."

    There's a school of thought suggesting some bacteria in the bowel being responsible for AS, with colitis and Crohn's being common. That may be why you were sent for an MRI to test for AS.

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  • Posted

    Hi Victoria,

    As I said on another thread, the first symptom of AS is inflammation at the sacro-illiac joints in the lower spine. This should show up on an MRI. In saying that, the other symptoms you describe sound like typical problems with the disease.

    Wait till you see what the rheumatologist has to say though, they are the experts. We're only guessing really; diagnosing from the Internet is never a good idea.

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  • Posted

    Thanks for your reply : ) unfortunately my Dr's have not referred me to a rheumatologist. The doctor I saw today told me that it was possibly muscular pain as it should get better in a couple of weeks with exercise pain relief (despite the fact that I have had pain for nearly three months) he also couldn't explain my knee or heel pain so I am going to see another doctor tomorrow to get their input. Thanks for the advice : )
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  • Posted

    My MRI was only for my lumbar spine. Not sure if this is the right location to show the inflammation you have mentioned. Not sure if I should bring it up with my doctor or not. Bit afraid that they may dismiss me straight away and think that I'm just a hypochondriac !
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  • Posted

    Thanks for all of your input. Have looked (with caution) on the Internet as I didn't know which sites were reilable and correct. Have found all your comments really helpful, sounds like you all really know your stuff ! Have seen another doctor and she has referred me to a rheumatologist today. Once again thanks for all of information : )
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  • Posted

    Hi Victoria;

    I was diagnosed with AS, not had an MRI, but received intensive special-angle X-Rays that clearly showed the problem. I live in California (ex-pat), but from what I've heard and read, getting diagnosed for AS in the UK can be a challenge, but I hope you manage to find out what is going on.

    However, if one is not being diagnosed, or mis-diagnosed, often there is no other choice than to be your own doctor to figure out what is going on, but it's always a good idea to test understanding anyway with the medical profession.

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  • Posted

    It actually can take years of having the disease before it gets to the point of as doctor diagnosing it. My son starting signs at the age of 7 but took till he was 14 before being diagnosed and I had three bouts of iritis till the doctor looked forward into it. My son and I were diagnosed 3 days apart from each other. Good luck and I hope that you don't have this awful disease.
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  • Posted

    Thanks Debbie : ) a lot of people are saying much the same thing. Have got a rheumtology appointment soon and am definitely hoping that they can rule it out. So sad that you both have it, especially your son : ( bet you are really close though. It must be nice for him knowing that he has someone to relate to. Wishing you both the very best of health. Hopefully one day there will be a cure : )
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  • Posted

    Thanks Victoria for responding to my reply. You are very correct on how close my son and I are. He is now 22 and has chosen not to take bio meds where I still am. There is a huge difference how how are diseases has different due to this. At this moment I think that it is worth the risks of taking the drugs. I actually feel sorry for my husband cause at times it feels like sometimes he's on the outside looking in. Anyways good luck and please keep me posted on how things are going. And if you have any questions please feel free to ask ....if I know the answers I'll definitely share what I've learnt over the years.
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  • Posted

    Thanks Debbie that's so nice of you : ) obviously would rather not have ankylosing spondylitis but if I do it's nice to know that there's lots of other people that live with the disease and there will always be lovely people to talk to : )
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  • Posted

    Hello Victoria

    I have only just joined the list, and found your post by chance. I was once diagnosed with Ankolosing Spondylitus after a series of X-rays and MRI scans by an orthopaedic surgeon. I felt the bottom had fallen out of my world, although at least I had a diagnosis after years of crippling spine and leg pain.

    I was lucky enough that my GP referred me to the Royal National Hospital for Rheumatic Diseases in Bath ( affectionately known as the Mineral Hospital or "The Min" , which is the leading specialist hospital for this disease in UK.

    Sent down there with my letters and copy of X-rays , the specialist there said immediately " These X-Rays are useless, there all of the wrong place, and sent me downstairs to have an X-ray of my Pelvis. Taking the X-ray back upstairs to him he said, "you definitely do NOT have AS. Apparently the first check before proclaiming A/S is to look at the Sacro-Illiac joint ( I think somebody else mentioned this) If you have A/S this joint will have fused together. Mine had not. The other thing he said was the orthopaedic specialists had misinterpreted the X-Rays of the spine. Whilst my vertebrae looked like a tent peg that's been hit so often the top surfaces had splayed outward, that was not A/S where in that disease the growth grow straight up and down and fuse together. Must admit at the time I fell apart crying. Years to get a diagnosis, then it's taken away again. However they were excellent as rheumatologist s, brought me in as an inpatient immediately, and put me on a course of intense hydrotherapy in their pool, and different drugs, and physiotherapy. The hospital was more like a spa retreat, right in the middle of Bath, so could go for evening walks down by the river etc. There were of course A/S patients there as well, who seemed to be being helped and managed enormously, and I think a lot of them had periods of inpatient treatment that they used to really enjoy. If you do have A/S diagnosed I do feel extremely sorry for you, but I hope this helps a little to explain its very important to get an expert opinion. I'm not sure where in the UK you live, but Bath seemed to get referrals from a very wide area. There is the National A/S society ( search Google) who have excellent ties to the Min and great support groups. Hope my tale of experience helps a little

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