@@sabbir4-z5v “Joined 3 years ago - no subscribers.” You must be a true expert! 🤟🏻

By all means, I will prepare that. 😊

💪🏻📺

My pleasure! 🫡

My pleasure 😊

Thank you, sure I will prepare something on X-rays.

Who’s reading X-rays of hands and feet at your institution, @immane75?

@@berlincaseviewer Radiologists.

In order to answer your question we might need to review your images. Please follow this link, fill in the information and drag/drop your images onto the form. public.berlincaseviewer.com/askdrkay

Thanks, Miguel! We are also ready to include one of your cases if you would like.

Thank you for your detailed question. The MRI findings you described-focal narrowing of the antero-inferior aspect/synovial component of the bilateral SI joints with symmetrical patterns, subchondral bone irregularities with erosive changes mainly involving the iliac side, and high signal changes on STIR with significant enhancement following contrast-are indeed suggestive of sacroiliitis. These changes are commonly seen in axial spondyloarthritis (axSpA). However, it is important to review the actual imaging studies to make a definitive diagnosis and understand the full extent of your condition or question. I would be happy to review your images and provide a more specific interpretation. Feel free to reach out if you have any more questions or need assistance with your case.

​​@@berlincaseviewerthanks a lot for replying my question. may i know how to reach out to you?

@@gaiksuanlee1910 📩 [email protected]

Exercises are helpful for many of these problems. While exercises and occasional painkillers are recommended for osteitis condensans and degeneration due to anatomical variants, it is now believed that stronger medication must be prescribed for axial spondyloarthritis, in parallel with physiotherapy. You should consult a rheumatologist.

The patient received NSAIDs, which he was taking daily. The disease improved noticeably in the first year. In the further course, however, the effectiveness decreased again. In the end, the decision was made to start biologics therapy.

So I have to do it again? 😉

No CT or X-ray is needed on a routine basis. If MRI is available, use it. In some circumstances, however, CT reveals additional information about the bony structures. Those are sometimes difficult to analyze exacly by MRI, as MRI depicts bone only indirectly.

Thank you so much for your professional explanation 😊

I'm always here to help. I'm just overwhelmed with clinical work - I'm sorry! I sent you instructions via email. Let's do it!

@berlincaseviewer Thank you so much dear professor, I know you are extremely busy with your clinical work, and I appreciate your help. I will upload the images or ask someone to help me, because, I'm not an expert on image and data transfer. Martin

Thank you for your appreciation! 😊

Please approach me on Instagram, LinkedIn or X.

@@berlincaseviewer Dear Professor, Thank you for your response. I will make an Instagram account, please what means X? Martin

@@martinfricek4787 Twitter is now called X.

@berlincaseviewer OK sure, thank you I will do. Martin

@@martinfricek4787 I suggest you use our contact form. berlincaseviewer.de/contact/

Psoriatic arthritis. Because of the arthritis I use voice recognition. Sorry about that

Perfekt! Dann sehen wir uns ja am 22. März (online)! 🤟🏻

I'm here to make more of these. 😘

Thanks for the visit 🙌🏻

MRIs are perfectly suitable for visualizing ligaments. It is important that a specialized radiologist looks at the images for the complex pain syndrome you have described. We are available for a second opinion. Upload the images here: cases.berlincaseviewer.com/secondopinion

MRI, is very sensitive for ligament assessment, u should try consultation with a rheumatologist or musculoskeletal pain specialist.

Have you spoken to your rheumatologist about this? There are a number of medications you can try. You also need to consider whether the diagnosis is correct. It may be necessary to get a second opinion on the images. Kind regards

It was an amazing trip. My first visit to India. 🇮🇳

😱 Thank you so much for your kind comment!

Treating psoriatic arthritis (PsA) is tricky because this disease affects both the skin and joints. PsA treatment includes a combination of medication and non-drug therapies like exercise, massage, heat and cold. It’s personalized to your symptoms and the severity of your disease. You may need to see a team of specialists, including a rheumatologist to manage joint pain and a dermatologist for skin symptoms. Medicines are an important part of treating PsA and managing flares. Psoriatic arthritis medications may include some or all of the following: NSAIDs (ibuprofen, naproxen), Biologics ((Humira), etanercept (Enbrel, Remicade, Simponi, Cimzia, and many more…), DMARDs (methotrexate, some newer drugs as well …), topical treatments (creams & ointments, please refer to a dermatologist).

you can talk to your reumatologist about Talz .20 years of psoriasis and the last 2 diagnosed with PSA .im 2 years on talz and with exersise and good food im managing pretty well , no pain(only after gym or yoga) and some fatigue .Hope that helps.

The exact cause of axSpA IS NOT CLEAR. Researchers believe that people with certain genes develop axSpA when they are exposed to a virus, bacteria or another trigger. Many people with axSpA have a gene called HLA-B27. But most people that have the gene never develop axSpA.

In this case, that's easy. We have the information about the inflamed sacroiliac joints and the L3 vertebral lesion on the anterior edge. It would be very unlikely if now at L2 there is no inflammatory lesion in axSpA, but a Schmorl's nodule with concomitant inflammation. But of course, if only the spine is present and there is only one affected segment, then you are in a fix. Some people say that you can differentiate by the location of the osseous defect within the endplate. Still others claim that the fluid content of the adjacent nucleus pulposus can be used. Overall, it is difficult and I have seen all variants of Schmorl nodes.

We always welcome guests here in our department. However, first schedule an appointment with a skilled rheumatologist who should double check your situation.