Re: Question regarding full body bone scan for rheumatoid arthritis

[Guest guest]

A bone scan will show osteo arthritis damage or osteoporosis.  Inflammation can only be evaluated by blood sed rate and RA level tests or physical exam.  Are you on a biologic?  If not you should talk to your doctor about being on one.  You can have OA and if you blood tests show RA factor positive then you have RA and OA.  RA can manifest and if untreated can damage joints manifesting Osteo Arthritis.  If you are working, then chances are, the condition is not as debilitating as it could be since you are working so much.  Stress can cause an increase in fatigue and bone pain.  Rest and the right medication should help.  Yours, Deborah

On Sat, Jan 16, 2010 at 11:18 PM, kathy_d87 <kathy_d87@...> wrote:

 

Happy New Year all! I've been working so hard hat I haven't been able to post anything in a long while.

Truthfully, my job has overtaken alot of my free time, which has resulted in me being a flare for the 2nd half of 2009. My test results in December were not good to say the least, lots of inflammation.

My rheumy is requesting a full body bone scan to see how much the inflammation has damaged my joints--I've had RA for 14 years now. I don't have visible damage in my joints, but the physical exams and my blood tests show otherwise. My knees and shoulders grind alot. I still have that stiff " flu like " feeling all the time.

My question is will the bone scan show the level of inflammation or just joint damage?

Thanks!

Kathy

[Guest guest]

I’m not medically trained but I think there might be two

different kinds of x-ray body scans. One is a Dexascan to measure bone

density and check for osteoporosis, and the other is to look at joints. I

think an MRI gives a lot more detail about the joints to see how badly the

joints are inflamed and to determine joint damage (but not bone density).

I think you are talking about the latter kind of body scan and if an MRI is

possible I think you should at least ask about it. Grinding in the knees

and shoulders sounds to me like you have significant damage to these

joints. I hope you get a good diagnosis and effective treatment.

God bless.

From: Rheumatoid Arthritis

[mailto:Rheumatoid Arthritis ] On Behalf Of kathy_d87

Sent: Saturday, January 16, 2010 7:18 PM

Rheumatoid Arthritis

Subject: Question regarding full body bone scan

for rheumatoid arthritis

Happy New Year all! I've been working so hard

hat I haven't been able to post anything in a long while.

Truthfully, my job has overtaken alot of my free time, which has resulted in me

being a flare for the 2nd half of 2009. My test results in December were not

good to say the least, lots of inflammation.

My rheumy is requesting a full body bone scan to see how much the inflammation

has damaged my joints--I've had RA for 14 years now. I don't have visible

damage in my joints, but the physical exams and my blood tests show otherwise.

My knees and shoulders grind alot. I still have that stiff " flu like "

feeling all the time.

My question is will the bone scan show the level of inflammation or just joint

damage?

Thanks!

Kathy

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11:35:00

[Guest guest]

Begging Deborah's pardon, usually the bone scan ordered by a rheumatologist (scintigraphy) is looking for inflammation, which it will reveal. It can also detect subtle fractures, infection or cancer. See below:

There are two kinds of bone scans. One tests bone density and is used to diagnose osteoporosis, a condition in which the bones become weak and brittle. The other, known as scintigraphy, is used to discover the site of a stress fracture or the presence of arthritis, infection, or bone cancer. This article discusses the second kind.

Bones are live, dynamic tissue that are constantly remodeling. Old bone tissue is dissolved, new bone tissue is created, and minerals are stored away for later use. The soft core known as the bone marrow continuously manufactures blood cells. These processes of growth and change are part of the body's metabolic process. The bone scan known as scintigraphy detects areas of increased or decreased bone metabolism and can indicate hidden bone fractures, bone infections, arthritis, cancer, or the cause of unexplained bone pain.Scintigraphy is a nuclear medicine test that requires no preparation other than the removal of jewelry, dentures, and any other metal objects. The only pain that may be felt is when tiny amounts of radioactive materials called tracers are injected into a vein in the arm.The tracers are radionuclides that are attached to particular biological molecules. These molecules are attracted to and accumulate in the bones, taking the tracers with them. The tracers emit waves of radiation that can be detected by a special gamma camera.It takes about two to four hours for the tracers to circulate and collect in the bones. Several glasses of water are drunk during this time, causing frequent urination. This helps to clear the body of the unabsorbed tracer materials.After the appropriate amount of time, the patient rests on a padded table while the gamma camera, housed in an arm-like device, passes over the body and records patterns of tracer absorption in the bones. It is important to lie very still. A scan of an individual bone can take from 10 to 30 minutes and an entire skeletal scan can run from 45 minutes to an hour.After the scan, the radioactivity generated in the body by the tracers (less than that of a chest X-ray) generally disappears within one to three days.The information from the gamma camera is recorded in a computer that processes the data and creates an image. Normal radiotracer uptake in the bones appears as a uniform gray in the image.Evidence of abnormal metabolism shows up either as darker "hot spots" with greater tracer uptake or as lighter, "cold spots" with little or no tracer uptake. Hot spots represent increased bone metabolism while cold spots indicate decreased bone metabolism. With arthritis, the tracers show up on the bone surfaces of the joints.While scintigraphy can detect subtle changes in bone before they are visible by X-ray, it does not necessarily determine the cause of an abnormality. Other tests may be performed to aid in establishing a diagnosis. The bone scan findings are then correlated with the test results, other imaging studies, and clinical information.

[Guest guest]

Thanks /, Harold, and Deborah. I just received a phone call from the

MRI place setting up my bone scan for Monday. And as you stated

//Harold, it will require the injection of the dye to take the scan.

It sounds very similar to when I was diagnosed with and treated with Graves

disease and the doctor took pictures of my thyroid with radioactive iodine.

Deborah -

I have used several drugs and biologics. Currently I'm using prednisone and

plaquenil. The drugs that have failed: Celebrex, Vioxx, Methotrexate (by

injection), Humira, and the latest Enbrel. I'm getting by on prednisone dose

packs when the swelling and inflammation gets too bad to handle. And now my

bursitis in my left hip has decided to team up with my RA to kick my butt.

The doctor is now trying to decide if he should try another biologic such as

simponi, or orencia, or go in the direction of a clinical trial. My doctor's PA

wants to try Remicade, but Methotrexate doesn't work for me.

In the past I've been against a clincial, trial, but now, I'm open for anything.

With my job being very stressful--workng 50 - 60 hour weeks, plus the possiblity

of layoffs looming, my stress level is off the charts and it's showing in my

labs--high SED Rate, high CRP, and my anemia has gotten worse. But the good

news is that I'm still seronegative which explains why the disease is probably

not showing in my joints, just my labs.

I'll keep everyone posted. Thanks again for the help,

Kathy

>

> Begging Deborah's pardon, usually the bone scan ordered by a rheumatologist

(scintigraphy) is looking for inflammation, which it will reveal. It can also

detect subtle fractures, infection or cancer. See below:

>

> There are two kinds of bone scans. One tests bone density and is used to

diagnose osteoporosis, a condition in which the bones become weak and brittle.

The other, known as scintigraphy, is used to discover the site of a stress

fracture or the presence of arthritis, infection, or bone cancer.

[Guest guest]

Had my bone scan Monday, 1-1/2 hour on a narrow hard table (ouch)--just waiting

on the results now. Waiting is the hardest.

No, I cannot take Remicade because I can't take Methotrexate. The rheumy said

you cannot take Remicade without Methotrexate. I failed injectable methotrexate,

and unable to take it by mouth.

My T3 and T4 are in alignment. My PCP checks them regularly. When I was

feeling yukky the last few months, I really thought my thyroid med needed

changing, but it was my RA and anemia.

>

> Dear Kathy- Have you tried Remicade. It isnt mentioned. I have

> hyperthyroid due to the RA, hot nodes on the thyroid glands. I wonder what

> your T3 and T4 are? If you havent tried Remicade, I would try.