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HLA-B27 Positive result (AS?)

salty444ssalty444 Posts: 149
edited 06/11/2012 - 7:57 AM in Arthritis, Osteoarthritis
Well, After 2 discectomy's, numerous injections, mri's, xrays, a short trip to a physical therapist (3x) my new neurosurgeon decided to get some blood work. Rhumatoid factor, lyme and HLA-B27... Well, it came back positive for the B27 test. Now I am scheduled with a rhumatologist (sp) monday the 21st.

needless to say with my current lumbar issue, DDD and now nearly bone on bone at l5/l4 i'm a bit freaked out. Do you think he will order new x-ray's, mri's or other tests? What should I expect on my first visit?


  • I am HLA-B27 and diagnosed with Ankylosing Spondylitis (HLA-B27 is a gene common to those with AS, but you can have the gene and not have AS). Take all your films and test results with you that you have so the doctor can have the fullest picture available. The rheumy will check on your flexibility/range of motion and it may help if you can describe your pain - where it is, level for the varying places, anything that makes it better or worse.

    I'm surprised more people on the site don't see a rheumy. With the issues with inflammation and all the issues, I am glad I've been seeing a rheumatologist.

    If you research AS, just know that women and men often are affected by the disease differently.

    You'll be ok.

    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.
  • Thanks Karen, My last mri was last year. Do you think the DR will order a new set? My pain is constant in my lower back/pelvic/hip region. I recently received facet block and an SI joint block which worked for about 10 days. Sadly, its long worn off and the pain is back. I wish there was something to keep the pain away for good. My wife keeps harping on me to go to physical therapy. Honestly, I tried it and all they did was cycle me from one bike to another and then had me push a squishy ball up a wall 100x. Basically, a waste of a $20.00 co-pay.
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  • Did the neurosurgeon think surgery is necessary?

    The rheumatologist might order other tests. Bring the films and the results. Make sure you mention the issues with the SI joints as well as the back. Some insurance is tough with the MRIs, so he might want to try some medication or another round of PT.

    Let us know how you're doing.
    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.
  • Karen,

    What kind of surgery? I've had 2 discectomy's already.... I have another appointment with the NS on the 22nd
  • I thought maybe because you were still seeing a neurosurgeon that he was considering that option.

    I read in another message that Kim is newly diagnosed with AS.

    I may be needing your advise as I'm going through shots in L4/L5 that thus far haven't helped much or for very long.

    All the best.

    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.
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  • Karen,

    I had 2 discectomy's. I went to another NS for a second opinion and he recommended the injections for now and ordered the blood work. So far I received the injections, 1 facet block and 1 SI joint. They helped for about a week to 10 days but my pain/symptoms just keep coming back. I've had a round of other injections before my surgeries for a nerve block which didn't help either. I have an appointment on the 21st with a rheumy and a follow up with my NS on the 22nd. I hope after 7 years of pain that this may be finally be figured out and I can get the right course of treatment.
  • Well im in dr office... wish me luck
  • Got my orders, more blood tests, MRI and xrays
  • Good to hear this Rheumatoid Dr. is very thorough and doing all the tests. Waiting for results is the hardest part. Did they order anything for the pain like anti-inflammatory or anything? Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • They may try you on some of the AS drugs, such as Methotrexate, Enbrel, etc. I was on sulfasalazine first, which made me very, very sick. From there I went to Methotrexate, which offered some pain relief for a short while, then stopped working and had me sick for two to three days each week. I've now been on Enbrel for six months; I had some relief with low back/SI/hip pain for a couple of months, but it has returned with a vengeance, so I see my rheumatologist again on December 2nd to see what our next plan of attack will be.

    I am HLA-B27 negative, but have some symptoms of AS and psoriatic arthritis, as well as osteoarthritis and DDD. The best relief I have had was from rhizotomies;
    I have had four of them, which helped me out anywhere from five weeks to several months.

    Sounds like the rheumatologist is being thorough, and they generally have a certain order in which they do things for these types of 'spondyloarthritis'. I hope you make some headway soon and have some more comfortable days ahead!

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