Rheumy is sure I have Ankylosing Spondylitis and not PMR
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I had a phone call from my rheumy last Saturday, the weather meant that I could not see him face to face and I had been waiting for the results of a second MRI on my lower back. He has never been happy with the PMR diagnosis from my doctor. The results are still not convincing as the report from my MRI was that there is deterioration which could suggest AS but could also be natural deterioration!!! Well, that helps and does not convince me that it is AS. It is being suggested that I move over to biological therapy drugs as they would be better for my Osteoporosis. He did this random 10 questions that asked me to say from 1-10 how my pain felt in different scenarios and the result of that I came out a 5 which apparently allows me to try the new drugs (anything over 4 is allowed) It all seemed a bit wooly to me! I am currently on 10mg of pred and apart of some days of fatigue and occasional aches I do feel ok. I am going to continue reducing pred on the really slow method. Do you think I should consider moving onto the other drugs? I have had very little side effects from pred so maybe better the devil you know? One thing that does make me think that maybe it is AS is that I have never not been able to work and many on here really can't. It seems that AS effects people differently so maybe the rheumy is right. Sorry to ramble but your thoughts would be gratefully received 
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0 likes, 6 replies
mary19068 elizabeth40672
Posted
Have you been tested for Human Leukocyte Antigen (HLA-B27) associated with AS., although not everyone who has AS presents with this gene....
EileenH mary19068
Posted
Or more to the point maybe - having the gene doesn't mean you have AS, there is a variety of options:
Diseases associated with HLA B27
• Ankylosing spondylitis
• Reactive arthritis (follows infection with species of Chlamydia,
Campylobacter, Salmonella, Shigella and Yersinia)
• Sacroileitis associated with psoriasis
• Sacroileitis associated with inflammatory bowel disease
• Undifferentiated oligoarthropathy
• Anterior uveitis
• Aortic regurgitation together with cardiac conduction abnormality
• Enthesis-related juvenile idiopathic arthritis
elizabeth40672 mary19068
Posted
Hi Mary, no I haven't. I will ask the doctor about it when I see her next. Thanks!
EileenH elizabeth40672
Posted
I would try it - he obviously has seen something on the MRI suggesting this may be the early stages of AS.
A very basic question (or two): is your back pain worse at night, 1-2am for example, and does Naproxen help your pain at all? Though if the AS is presenting with the soft-tissue aspects early on then they may not be so significant. There are other spondyloarthropathies besides AS that affect different bits differently.
I know a few people who were originally given dx's of PMR but had problems reducing the pred dose - but have done brilliantly on anti-TNF drugs.
elizabeth40672 EileenH
Posted
Hi Eileen, no back pain is not worse during the night. They seem to be going on a lot about my lower back but when this kicked off I had no lower back pain and still don't. However, I have suffered from lower back pain on and off from the age of 20 but just put it down to bad lifting. I currently wake up a little stiff in the morning but that is about it. Naproxen did not help at all.
EileenH elizabeth40672
Posted