My initial symptom was disabling pain in my right hip and very low back pain. The area of my back that hurt was right where the indents are above the buttocks. That is the area of the SI joints. Since then I have had two flare ups of the SI joints that were 10 times worse than the first. Extreme buttock pain radiating down my legs. Unable to bear weight on the legs, bend, or sit. For the last 10 years I have stood to watch TV because I cannot sit for any length of time.
You are correct that damage will not show on the xray for some time. That is why MRI is superior in diagnosing sacroiliitis. When I have a falre up my rheumy immediatel orders an MRI. Then off to the spine guy to get my SI joints injected.
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CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, and a host of other medical problems.