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1549643 tn?1495759353

Will MRI show chronic inflammation?

Would inflammation of joints, enthesitis, or tendonitis show up on a MRI with contrast if there is no visible swelling in that area?
Best Answer
1530171 tn?1448129593
An MRI cannot distinguish chronic form non-chronic inflammation.
In the absence of swelling, the inflammation might be  more challenging to
detect in an MRI.
MRIs are great to show detail in soft tissues with fluid content AND swelling.
I don't think MRIs are needed for tendinitis-an X-ray would suffice, but for
inflammation of joints I believe MRIs would be better for showing both better degree of erosion and inflammation.
On the other hand  inflammation from enthesitis or even enthesitis in its entirety may be missed, like in spinal imaging in the absence of swelling and the fact that there are limited fluids in that region.

You would need to speak with your doctor or the radiologist about this, as there are too many variables and also this is a field dealing with very subtle details, something clearly not possible to discuss here in this forum.

I hope this helps.
Niko
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Avatar universal
My rheumatologist used ultrasound to see my inflamation. She used it on my joints so I am not sure if it could be used in wide spread areas.
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Avatar universal
I have widespread inflammation without swelling (aching tendons, ligaments,tissue near joints) and 1:320 ANA with low C3 and C4 but normal inflammatory markers=>docs say MixedCTD.  I am 33 and have trouble walking.  I am trying MTX with prednisone 10mg as of 3 weeks.  Considering plaquenil...did it help you?  
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1530171 tn?1448129593
OK, have you looked at low thyroid function? which could be totally missed by standard thyroid testing if it type 2 thyroid resistance (more prevalent).
To rule out this you need Free T3, Free T4 and Reverse T3.

When thyroid function is low, all cells are struggling, as repair maintenance and healing are impaired, more or less, to the degree of thyroid function impairment.
You could have a low grade ongoing infectious condition within the synovial fluid and surrounding tissues away from the blood circulation, making it next to impossible to detect.  
I think a synovial fluid analysis will detect any abnormalities there.

Cheers,
Niko
Helpful - 0
1549643 tn?1495759353
I have widespread bone pain and pain on the bones of the joints but on the outside of the joints. Severe chronic fatigue. Could make a long list of my problems.  

1:640 ANA but normal inflammatory markers.

If there is an autoimmune condition genetic in my family, as there are many of us that have problems and no answers, my guess would be something seronegative or psoriatic arthritis. I'm the only one with the positive ANA. 3 of us have been told it's fibromyalgia, some of my family hasn't even been able to get a diagnosis at all. My fatigue does not come from lack of sleep. My mom has symmetric joint damage and swelling, burstitis,  psoriasis, never feels good but only dx is OA as the doctor claims there's no way to tell the difference.


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1530171 tn?1448129593
My dear MaryAlice you should rule out Tension Myositis
Tension Syndrome (TMS).

Please consider looking into it , as whatever you're posting is fairly consistent with the hallmark signs of TMS.

I have explored this field extensively, read a couple of Dr John Sarno's books and also done the free online courses, before coaching other people.

After you familiarize yourself with TMS and find it meets the basic criteria, you need to find a TMS doctor to diagnose you.

If you need any help with this, please let me know.
I'll be away for the summer, so my online presence will be limited, however, I'll still respond eventually.
So, don't think I might have forgotten, in case it I don't respond timely.

It could of course be  due to other causes and imbalances, which don't necessarily show up on imaging tests, like compromised synovial fluid , cartilage composition integrity and others (which are usually linked to arthritis).

I hope you find the answers you're looking for.

Blessings,
Niko

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1 Comments
I’ve read Sarno’s first book.  Do you know of Drs who specialize in TMS in Omaha NE?
1549643 tn?1495759353
I was taking plaquenil, and medrol packs as needed, but I haven't been on these medications for 6 months. Currently, just ibuprofen. Trying to find out what is going on. This illness has ruined my life and I want answers.

The MRI on my spine showed various things, diagnosis of osteoarthritis and degenerative disc disease.

The sacral MRI (no contrast), it showed nothing. I was beyond shocked. The pain/stiffness is crazy. I have trouble standing, walking, bending forward, and sometimes cannot even straighten my back.

Limping from bilateral achilles heel pain and xrays show nothing.

I just wonder if there is an imaging test that will show chronic inflammation with someone that A: has no visible damage and B: rarely swells.

Nuclear bone scan of the entire body, muscular ultrasound, MRI with contrast? Would a doctor actually need to biopsy the joint.

My primary doctor talked like inflammation without swelling would not show up on a MRI.



Helpful - 0
1530171 tn?1448129593
Hmm, the inflammation would be definitely less defined, specially in the spine due to the limited amount of fluids present.
In the end, inflammation is a physical symptom we experience and imaging tests due to their limitations do not do enough " justice" to make a notable difference in the outcome, other than putting patients' minds at ease perhaps.

What are you presently doing to address the inflammation?

Niko

Helpful - 0
1549643 tn?1495759353
Will inflammation still show up in the joints or spine if no contrast is used?
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1549643 tn?1495759353
Very helpful. Thanks!!
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