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Forum Name: Rheumatology Topics

Question: Can you have both AS and RA


 jmssk323 - Tue Jun 29, 2010 12:31 am

I am a 37 year old female who recently in April 2010 began experiencing chronic joint pain. I have a postive CCP Positive HLA-B27. My ESR and C reactive and RF are normal.

Due to my insurance I am having a hard time with the doctors. My primary says its RA my Rheum says its likely AS w/ peripheral arthritis although he did no tests to confirm. I have not had an MRI of the spine because primary doesnt think neccesary and needs to authorize because rheum wont have his staff spend time calling for authorization.

I just want to know what is wrong.. Is it possible to have both rheumatoid arthritis and ankylosis spondylitis. My father has severe AS. My mother had RA. The rheumatologist noted tenderness and inflammation of the sacroilliac joint but also at the finger joints, toe joints. I have a synovial cyst on my wrist and carpal tunnel which gets worse with the inflammation. The carpal is diagnosed with nerve conduction test.
So could it be both? I NEED A DIAGNOSIS the waiting for answers is causing me so much grief.
Are there any case studies of someone having both?
 Faye Lang, RN, MSW - Sun Jul 04, 2010 5:23 pm

Hello, jmssk323,

Your situation is complex, and I'm sorry you are having such difficulty communicating with your doctors. It is possible to have both RA and AS; your laboratory findings tend toward AS, and the signs in your peripheral joints tend more toward RA. In the early stages of AS, radiographic changes in the sacroiliac joints may not be discernable by regular X-ray, but would need a CT scan or MRI. Since you've been dealing with this since April, it's still fairly early and the CT scan or MRI is warranted. If your physicians are not responsive to your concerns, please discuss it with them very clearly. Perhaps they would prefer that you change to alternate physicians, which should be possible regardless of the type of insurance that you have. The reluctance to help you obtain a necessary diagnostic procedure is puzzling; please ask them why this is an issue. You are entitled to appropriate medical care, as I'm sure your physicians would agree, and any office staff should be very willing to obtain the authorization required if the physician requests them to do so. That is totally within the context of such employment parameters. Early, appropriate treatment is essential to the best outcome and management of either of the conditions that you may have. Please advocate for yourself clearly and emphatically. I hope this is helpful to you.

Good luck to you!

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