The Limp Saga, part 2

I've posted before about Sam's limp. (Need the backstory?  You can read it here.)  Well the saga continues.

After a 6 month wait we FINALLY had an appointment with the rheumatologist.  Dr. DeGuzman is AMAZING!!  She did a thorough physical and took the most complete medical history of all time.  She wasn't phased at all that she saw Sam on a "good day" (meaning his limp was so incredibly minor it was difficult to appreciate it during exam). She had no doubt that we had seen him in much worse shape -- I didn't even have to pull out my phone to show her videos as proof!

The good news -- it doesn't appear to be muscular in nature.  Dr. DeGuzman honed in on the fact that I have Crohn's.  This, combined with that Sam has pain in his sacrum, has Dr. DeGuzman hunting for a particular genetic marker, hla b27.  Basically sacrum pain in kids as young as Sam is super-rare. The genetic marker we're looking for is seen in people who have a negative rheumatoid factor (which Sam has) but who have a particular type of arthritis (not gonna name it now b/c we don't need to start researching it until we know).  She also mentioned that his pain could be a precursor to Crohn's (which also shares the hla b27 gene).

Sacrum pain is difficult to examine because of the location (base of the spine).  Dr. DeGuzman said Sam's muscles reacted to the pain but she wants to see that joint better.  Soooo today we are heading to TCH-West Campus for an MRI.  While there she is also having his left foot scanned as well.  Remember the last bone scan?  And how we were told it showed he limped?  Yeah...apparently it was the wrong foot that showed that limp.  The bone scan shows blood flow in the bones.  If Sam had been favoring his right foot, his left would have shown an increase in blood flow.  But that's now how it worked out.  He was favoring his left and it was his left that showed an increase in blood flow.  Thankful Dr. DeGuzman caught that!  She examined his foot closely and found that he has mid-range pain.  What that means is this:  On the scan, there is a HUGE white spot on his left foot (showing the increased blood flow) in the middle.  When she stretched and bent and twisted his foot, she was able to determine that his foot is causing him pain (in the middle, not the toes or heel).  Because of all this she wants an MRI of his foot too.

If you think about him today, would you pray for sweet Sammy?  It's a no-big-deal MRI but he has to be sedated which always makes me a bit nervous.  I'll keep you posted as we get new info.