Wrist Pain: Eroded but not arthritic?

I went to see the hand surgeon today. He went into more detail than the rheumatologist about my MRI scan. Apparently, most of my wrist is in bad shape. Most of it is inflamed and not only have some of the bones been pushed out of place but they seem to have been chemically eroded by the inflammation (I guess by the production of "toxic" chemicals). Isn't the body wonderful.

The expert who reviewed the MRI scan wryly wrote than the only "normal" area is the one from which arthritis starts. So, maybe the good news is that I haven't got arthritis. I'm not raising my hopes too much.

The surgeon said that the arthroscopy that the rheumatologist recommended wasn't going to cut it. He frankly admitted that such a small cut meant that he sometimes couldn't get enough tainted tissue for analysis. So, to do the biopsy and get enough crap out, he wants to do a bigger, "open" cut, that'll probably leave a 2.5 cm scar.

The good news is that there's a slim chance of getting it done on the NHS in 5 days time. This would be quicker and cheaper than a £2000 private operation. I'm not raising my hopes too much.

I'll know by Friday.

I moaned about having a blood test, MRI scan and biopsy and still no treatment. I'm frustrated. If it's TB, they could give me the antibiotics saving time, pain & money. If it isn't, I wouldn't have lost less time or money, than waiting for a diagnosis.

I remember my school science. First, form a hypothesis. Then, carry out an experiment to test the hypothesis. Finally, analyse the data to see if it supports or refutes the hypothesis. In this case, it would be quicker & cheaper to try treatments to see if the hypothesis is correct.

The surgeon said that if it isn't TB, then the antibiotics could cause a problem but was vague on the consequences. I think he didn't like my idea of hacking scientific method.

Wrist Pain: MRI & Blood Test results

I went to see the rheumatologist again today to discuss my MRI scan and blood test results.

The blood tests were fine.

He said there is lots of inflammation and fluid in the wrist. Well, I could have worked that out without an MRI scan.

Here are a couple of views of my wrist taken by the MRI. The scan took lots of slices at different depths of the wrist and from different angles, eg top, side.














[view from top]











[view from side]

Unfortunately, some of the little bones in my hand have been "disrupted", which means that the ligaments which are supposed to be holding them in place are all over the shop and the bones are out of position.

Possible causes are TB (Tuberculosis) or arthritis. Apparently the BCG injection I had in school doesn't protect against getting TB in a joint and there's a lot of it about.

He suggested having an arthroscopy and a biopsy. That means he thinks I should go to a hand surgeon to cut open my wrist and poke around to see what's wrong which apparently the MRI can't show. Then, on the way out, he'll cut off a bit of my wrist for analysis.

I can just imagine the CSI CGI - whirring circular saw cuts through flesh like butter, blood spurts out, we fly with a camera plunging into the wrist and zoom into the bones and ligaments. The camera is rapidly withdrawn to be replaced by a shiny sharp scalpel that, with a flick of the wrist, cuts a chunk of flesh which is grabbed.