Thank you both for your answers. I can probably get in with my upper-extremity guy- I have one I've used before and think the world of- long before I can with the rheumy. The cost of MRI is off-putting, especially if it turns out to be poorly interpreted. Sally, you're absolutely right about imaging being no better than the person who reads it. The radiologist's knowledge, or lack thereof, of rheumatology will make a big difference on what kind of information one gets.

Since I have PsA, enthesitis is no doubt where this started, but I think it's gone beyond that.

Jen, how well did you heal from shoulder surgery? I've heard such mixed things. You've had every surgery in the book and then some, haven't you?

Between the two I would suggest an orthopedic..but I also might suggest you look in your area with your medical board (online) and do a search for specialists in your area..maybe you might find an specialist with some knowledge in both areas

Unfortunately, Annette, no such critter without a long drive. I live in a one-rheumy, two-upper-extremity-orthopods town. As I said, I'm convinced that one of the ortho guys actually, personally, hung the moon. I guess I should give him a call

Sally, I was surprised when I first went to the second hand guy following failed hand surgery by the first. He was able to just pull up x-rays taken in the first office, even though they were not affiliated. He also got my surgical records faxed over immediately, although with that one he handed me the phone to tell the surgical center it was OK.

I'm still curious, though: is there any way other than intuition to suss out whether one has an injury or just a new chapter to the old sad story?

@51%--
I had that too-- only on the Rt. shoulder so far. Its called a distal clavicle resection. I had a torn rotator cuff and a torn labrum repaired at the same time. They also did my Rt. carpal tunnel release during that surgery. Let me tell you-- I was in some serious pain afterwards.