Ultrasound today

pmcg1

I was diagnose with PSA nearly 2 years ago after an mri showed synovitis in my hands and feet. I've been on 3 dmards so far and they want to put me on biologics now.

Today they had me in for an ultrasound and x rays. The ultrasound showed a tiny bit of synovitis in one hands but also showed some fluid in a few areas.

I am exhausted and in pain every day and now have to wait over six months for a new mri before they can refer me to the biologic team.

Is it usual for a ultrasound not to see much inflammation?

Arciere

Hi there

My PsA diagnosis was confirmed by symptoms, ultrasound and blood test results.

I tried two DMARDs before being prescribed Biologics. However - once I had been diagnosed, I didn’t need further diagnosis assessment to move from a DMARD to a Biologic medication.

So I wonder if you can call your local NHS Rheumatology advice line about your quandary to see if you can get a second perspective on the process to move from a DMARD to a Biologic?

Not sure about the ultrasound capabilities but if it helps, when I had mine, the operator could clearly see the inflammation.

As for your pain, I found oral steroids to be quite effective.

Hope this helps

claudsl

Hello @pmcg1

From my own personal experience, ultrasound scans have always showed up inflammation. My consultant has always shown me where my inflammation is throughout scans. I'm sorry that the wait is so long for you to get started on biologics, i think the advice from @Arciere is very helpful though that you could perhaps try to get on a course of steroids or similar as a short term relief while waiting. This is definitely something you should look into. Biologics have great success stories so at least you know you will be starting them.

Hope this helps, Claudia x

Arthuritis

@pmcg1 @claudsl @Arciere Agreed, been to several different U/S joint scan sessions in both outsourced private sector and NHS, and it really comes down to the instrument capability and the operator’s skill. One private sector operator was really really good and was able to confirm everything I could feel, with great precision, the other could see it but not so good with guided injections and the nhs one did well with the one she could see, but couldn’t see anything on the second one (smaller joint needing either a different probe or skill set) . Ultrasound is not expensive like MRI, so well worth asking for a second scan. My employer made the MRI arrangements (private) and that could see everything in minute detail.

pmcg1

Thanks All. In Scotland they won't give you biologic meds unless they can see you have inflammation when they put you on it. My first mri 2 years ago showed inflammation in both hands and feet so I don't understand how they can't find inflammation with the ultrasound..

Anyway I'll wait for the mri in about 6 months lol