Is there a "right type" of MRI for diagnosis?

[MizDiana]

I don't have a diagnosis - PMR seems more likely, but Ankylosing Spondlyitis and some form of Vasculitis also seem possible.

My rheumatologist has ordered an MRI of the hips & neck ("Pelvis W/o Dye" and "Cervical Spine W/o Dye").

I had assumed some sort of contrast dye would be used to pick up inflammation - but honestly I'm just very ignorant here. I don't have a ton of money to pay for MRI procedures (U.S.A. patient here), so I'd like to get it right the first time.

Is this the path that's most likely to produce useful results for the rheumatologist?

[PMRpro Ambassador]

link.springer.com/article/1....

According to this MRI can detect PMR but I understand it to mean that with contrast is better if specifically using it to diagnose PMR rather than looking for degenerative changes or ruling things out. The Introduction explains it fairly clearly (to me, I know not everyone will think the same!).

If the rheumy is using it to rule something out w/o dye is probably fine. But with contrast could provide a definitive PMR diagnosis if that is what you have.

[Offcut in reply to PMRpro]

Interesting reply I found I was allergic to iodine/dye after my first scan. Made my BP drop to the bottom of my socks! But do agree dye will show up more and I hate to think how much extra it will cost in the USA?

[PMRpro Ambassador in reply to Offcut]

That's as good a reason as any NOT to have contrast, though there are different sorts. Thank goodness for the NHS and all the other European (almost) free-at-point of delivery systems. Our co-pays here in Italy were at least low and you were exempt for certain conditions/low income.

[MizDiana in reply to PMRpro]

Thank you very much!

[AtopicGuy]

This 2022 study of 16 PMR patients used non-contrast MRI to look at shoulders and hips. Six patients also had their spine scanned. Three patients later had a contrast added as a follow-up.

ncbi.nlm.nih.gov/pmc/articl...