[Lani]

rina-- A DEXA scan could easily be normal on someone whose steroid usage caused avasular necrosis (osteopenia/osteoporosis from steroids and avascular necrosis from steroids are two very different things) Avascular necrosis can happen many years later, as well.

YOu may very well have heard of avascular necrosis of the jaw caused by bisphosphonates (that is another nonweightbearing joing, but one many of us use quite often!!)

The test which best detects AVN, especially earlier than other tests and before collapse has taken place and sometimes before symptoms have occurred is an MRI>

I only questioned whether an MRI had been done to look at the health of the bone in your OTHER humeral head, ie whether it was beginning to show signs of avascular necrosis as well. I say as well not knowing that that was the cause of your current shoulder's problems, but aware that it can be the cause of quick deterioration to bone on bone in a relatively nonweightbearing joint. I only thought that bit of information might alter your decision and maybe your doctors' recommendations.

Did you have steroids with your chemo as well?

What medication(s), if any, are you taking for your Sjoegren's or is it relatively quiescent at the moment? Have you been allowed to take antiinflammatories and have these made any diffference? Has your pain gone away at all after the injections?

Just because your shoulder MRI and xrays look horrible may not mean those
changes are the cause of your pain. If injections given into the glenohumeral joint did not help (vs. helped by wore off) might not a repeat MRI of the Cspine help to rule out other causes of your pain? If it did relieve your pain, but just wore off, then I can see why you weren't in the mood to re-examine your neck when the local anesthesia had proved to you your pain could be relieved if that joint was made dumb.

I will be travelling for the next three days or so, so if you don't hear from me it may just be I don't have good internet access. In the meantime, best of luck!