Scans, what are they looking for?

[Parami]

Following an ultrasound on temples that found borderline something or other, I had an isotope bone scan and then a pet ct scan of chest, abdomen and pelvis. I'm wondering what they were looking for. I have an appointment with the rheumatologist next week and want to be prepared. Any ideas?

[Blearyeyed]

Have they told you that they are now looking for signs of GCA or something else?

As GCA can have an affect on other arteries not just those at the temples people can have scans done on these areas to check for the affects of GCA and to rule out other Conditions that may present like GCA . It is to help with getting a more definitive diagnosis or to monitor you for other underlying Health causes before making a final decision on your required dose and Full Care needs.

Sometimes they will also check the bones and do scans in these areas with PMR as well if you have not been responding well to treatment or have had severe side effects that haven't improved while tapering , again to rule out any other health causes before making a decision in your Drug needs .

It's a positive thing , it means they are being thorough in your treatment , that they can help you more as you move forward, and you can get reassurance when things pop up as Normal .

[Parami in reply to Blearyeyed]

Received a copy of the letter rheumatologist sent to gp, just after I posted. It states likely cranial GCA of 0.42, 'however it is uncertain', with positive halo. I suppose that uncertainty led to the other scans. Another thing to worry about 😕

[Blearyeyed in reply to Parami]

No , a comprehensive set of tests to find the root cause is being done which will resolve your diagnosis and whatever the outcome send you down the right treatment path to recovery . I have found over many years of tests and diagnosis that if you can alter your mindset from negative concern to positive reassurance when thinking about what is being done it helps you to remain calm and reduces the effect of Stress of the Unknown on your symptoms. Thorough testing us always a really good thing because it can rule out nasties and put your mind at rest.

[Parami in reply to Blearyeyed]

That is very true, and thank you for that. I do try to be positive, but the occasional worry creeps in sometimes 😊

[Blearyeyed in reply to Parami]

I think of it like a Mental Health supplement , it's just a thought based instead of drug based medication . A little dose of Realism Positive each day does me good , and I increase the dose of it at times when the tests pop up and the worry tries to step in !😋😂😂😂😁

Good luck next week , whatever the content we will be here to hold your hand and get you through it xx

[Parami in reply to Blearyeyed]

Thank you 😊

[PMRpro Ambassador]

The PET scan will have been to look for sites of inflammation in the arteries and joints to show if you have PMR/LVV/GCA although it is more for LVV (large vessel vasculitis) than GCA which requires a biopsy to say it is GCA rather than LVV due another underlying cause.

The isotope bone scan shows conditions that don't appear on x-rays:

mayoclinic.org/tests-proced...

with less radiation exposure than a CT scan.

The ultrasound on the temporal artery is looking for signs of GCA - a halo sign is seen:

academic.oup.com/rheumatolo...

This is due to thickening of the artery wall with fluid which shows up black. There is also something called the compression sign and stenosis - the artery is narrowed. You can see them in Figure 2.

They possibly saw early/late signs which weren't as clear cut as those images so then did the other tests.

[Parami in reply to PMRpro]

Yes, makes sense. Have just replied to Blearyeyed that there was some uncertainty after ultrasound, although a positive halo was seen. Not sure what that all means for me, but will be seeing rheumatologist next week. Thank you.

[SheffieldJane]

My scans have been looking for large cell Arteritis. They really should explain it to you. They will be checking you for GCA too I guess. You are lucky to have access to expert ultrasound. It is rare in the U.K. your preparation for the Rheumatologist, will be a list of questions, I guess.