Your MRI shows early/mild to moderate changes in the left hip and sacroiliac joints (SI joints):
• Mild fluid in the joint (effusion) — small inflammation.
• Erosions + small cysts under the bone (acetabulum) — some bone damage started.
• Mild bone swelling (marrow edema) in the top weight-bearing part of the femoral head — active inflammation there.
• Chronic sacroiliitis (both sides, right worse) — typical for axial spondyloarthritis (axSpA or ankylosing spondylitis type).
The damage is not advanced (no severe narrowing of joint space, no big bone destruction, no collapse mentioned). It’s early stage — many people catch it at this point. With good treatment now, you can stop or slow progression a lot, reduce pain/stiffness, and live a normal or almost normal life for many years (work, walk, exercise without major limits). Hip replacement is only needed in late stages if untreated for long time.
Is it curable permanently?
No full permanent cure for this type of arthritis — it’s a chronic condition. But yes, very controllable — modern medicines + exercise can keep it quiet for long periods (remission), prevent worse damage, and give excellent quality of life.
How much time to take medicine?
Usually long-term (many years or lifelong) to keep control — but doses can often be lowered if stable. Regular check-ups (blood tests + symptoms) every 3–6 months to adjust. Some people stay well on lower doses or even try to reduce after years of good control — doctor decides.
Next Steps
1. Continue current medicines exactly as prescribed (Dsaaaz / sulfasalazine, Folitrax / methotrexate weekly, folic acid, painkiller when needed).
2. Go back to a rheumatologist (best specialist for this) as soon as possible. Ask them clearly:
• What is the current stage of my hip damage?
• What is the expected prognosis with treatment?
• When do we repeat blood tests / MRI?
• If pain / stiffness stays, can we add a biologic (injection like adalimumab, etanercept, secukinumab)?
3. Start daily gentle exercise (walking, swimming, hip stretches) — very important to keep the joint mobile.
4. Do blood tests regularly (
liver,
kidney, CBC) while on methotrexate — standard safety check.
Health Tips
• Methotrexate (Folitrax) is safe for most people at weekly low dose + folic acid. Serious problems (
liver/
kidney/blood) are rare when monitored every 1–3 months. Avoid alcohol completely.
• Eat anti-inflammatory foods: more fish, olive oil, vegetables, fruits, nuts; less
sugar, processed food, red meat.
• Keep good posture, avoid long sitting without breaks.
• Maintain healthy weight — extra kilos stress the hip more.
• Track daily: pain level (0–10), morning stiffness time — write it down for the doctor.
You are diagnosed early — this gives you the best chance for excellent long-term results.
Stay on treatment, exercise gently, follow up regularly. Most people with your MRI findings do very well.
If you want help preparing exact questions for your doctor or want to discuss your latest blood reports/symptoms, you can consult with me online.
Take care and stay hopeful