Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Finally seeing a Rheumy

Well, all this time I've been trying to go the "natural path" but got hit again with scleritis. Always me and the eyes...

Thinking, again, that I had something in my eye, I went to Urgent Care, and again was given the wrong eye drops. The following Monday, I went straight to Ophthalmology and the Dr. there made sure to get me in the "system" so that the next time, I'm given the right medication based on my history of eye problems.

Then I decided I should be in the "system" with a Rheumatologist. I have to be referred, surprise! Got an appointment with a GP, and got the full treatment. X-Rays of the entire spine and SI joints, and the full AS blood workup. At least now I'll have a definitive look at the whole thing.

HLA-B27 was negative three years ago, but this doc wants it on her books as well.

So, here's what the spine X-ray results are. I'd like imput, please.

FINDINGS: Two views of the cervical spine demonstrate moderate disc height loss at C5-6 and C6-7 and mild disc height loss at C7-T1.

Two views of the thoracic spine demonstrate moderate degenerative changes of the upper to mid-thoracid spine.

Two views of the lumbar spine demonstrate moderate to severe disc height loss at L5-S1. There are lower lumbar spine facet degenerative changes.


Apparently, there is no "effusion of the SI joints" according to the results, even though I have hip pain and have osteophytes on my left hip.

So, even though I now have actual X-Rays taken by a medical center, I'm more confused than ever. Two Ophthalmologists have told me AS is the cause of Scleritis, yet I'm not told that there is certain fusion of the spine, only "disc height loss."

Just finished with the worst-ever flare-up. Pain in ALL joints. Lower intestinal swelling and bloating, knee pain, hip pain, face pain, the worst back stiffness in a long time on standing up (from the couch or from bed, you pick), chronic cough. It all started with a head cold back in August and got worse and worse over two months. This week is the first week I feel somewhat normal, with the exception of my tailbone, which is very painful ALL the time right now.

Anyone?

What I understand is that AS generally does not cause disc height loss. Everybody loses some disc height with age, but your moderate to severe height loss sounds like that is exceptional and could be the result of DDD (degenerative disc disease)or some other ailment. When AS is advanced enough to cause bridging (bone fusion) of the disc spaces, the disc spacing remains the same as it was prior to the fusion. Facet joint degenerative changes are also part of the aging process. I would ask your doctor to explain the condition of your spinal changes compared to others of your same age. The moderate degenerative changes of your thoracic spine might be AS related, depending on what the changes are. Some of the signs of AS (or other arthritis) are erosion and squaring of the vertebrae bone.

If you want to compare with my spine, I am in my mid 40s. My lumber spine is fused at every disc joint. The radiologist report says that I only have mild disc degeneration of the lumbar spine, and moderate hypertrophic facet arthrosis at each level.

You also might want to see a spine specialist instead of a rheumy, especially if the rheumy suggest it is not arthritis related.

Has your doc mentioned infectious diseases? My ophthalmologist tested me for TB because he said TB can mimic AS and also cause eye problems. With your persistent cough, I wouldn't rule this out.

Thanks for the response, very informative. I, too, thought that seeing a spine specialist might not be a bad idea, but I'll def bring up TB as well...just to be on the safe side.

Best of luck with your rheumatologist appointment. Is this the first time you are seeing a rheumatologist?

While scleritis can occur in AS patients, AS is not the first diagnosis that would (or should) leap into a doctor's thought process when evaluating a patient with scleritis. It is actually a much more common occurrence in patients with other collagen vascular disorders like RA or Lupus. Since you have mentioned that you are HLA-b27 negative, it would be interesting to know what other factors led your ophthalmologists to suggest AS. Regardless, the rheumatologist is the best person to determine if your symptoms are being caused be AS or a related disease.