It's completely understandable to feel confused when your test results and specialist opinions seem to be pointing in different directions. Let's try to break this down a bit.
Your MRI findings (tendonitis, fluid in the subdeltoid bursa, and a small effusion) can all be associated with RA-related inflammation in the Show Full Answer
It's completely understandable to feel confused when your test results and specialist opinions seem to be pointing in different directions. Let's try to break this down a bit.
Your MRI findings (tendonitis, fluid in the subdeltoid bursa, and a small effusion) can all be associated with RA-related inflammation in the shoulder. However, your rheumatologist is seeing the X-ray results and interpreting the joint changes as being driven by wear and tear rather than active RA inflammation. The fact that your sed rate (ESR) dropped significantly from 33 to 10 after the cortisone injection is actually meaningful. It suggests there was active inflammation present that responded well to the steroid — which is a hallmark of RA-related inflammation rather than purely mechanical joint changes.
That said, it's possible to have both happening at once. RA can create an environment in a joint that accelerates wear and tear over time. Some helpful steps to consider:
- Ask your rheumatologist directly about whether RA could be contributing to the shoulder changes, given your sed rate response to cortisone
- Request clarification on whether your overall RA disease activity is being monitored alongside the shoulder symptoms
- Consider a second opinion from another rheumatologist if you still feel your concerns aren't being fully addressed
You deserve clear answers, and it's absolutely okay to keep asking questions until things make sense.
August 10
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