Newly diagnosed - psoriatic spondylarthopathy. Bit confused

dopeykit

Hello,

I posted a while ago following an op I had to sort out my funny shaped hips and had a good whinge as my diagnosis was in question. I'm really please I have a proper diagnosis now (after oooh 5 years at least) but still quite confused.

I saw a new orthopod and rheummy since then and they say I have two things:
- psoriatic spondylarthopathy
- spondylolithesis - some kind of funny fracture in my back from falling downstairs as a child

The second one seems to be a straight choice of spinal fusion or not (and if anyone has it I'd be really interested). But I don't really understand much about the psoriatic one. I mainly have lots of pain where my tendons attach to the bones and lots of bursitis. My patch of psoriasis is soooo tiny it seems strange it could cause all that.

Can anyone tell me more about their experience of it and what the treatemnt is? I'm haveing some tests on the tendons and then they want to start me on different drugs but they rheummy was very very vage (and a bit too grumpy to ask(.

Thanks very much

kit

valval

kit can not help much but did read a post where some one who has no phsoriosis (sorry spelling) has had it but did u look under living with arthritis to see what it says

kmt297

Hi Kit,
I have Psoriatic arthritis with spondyloarthropathy and enthesitis (inflammation of the insertion of tendons into bone). I was diagnosed in 2005/6. Initially I was prescribed methotrexate with is a DMARD (disease modifying anti rheumatic drug I think) but it wasn't enough and I've since been through all 3 anti-tnf drugs available for PSA, now on Humira which is not really working very well but there are no other options... The enthesitis is troublespme for me - nothing shows on x-rays or blood tests so it can be difficult to get people to understand how much it affects me - I don't even gor much visible swelling of joints in the traditional RA style. But I manage to work and have a semblance of a social life - I've learned to pace myself better and take rests lots.

If you've got any questions please ask me - I've been living with this for a while so may be able to help.

KT

dopeykit

Hello

Thanks for the replies.

KT - bit dangerous to offer to answer my questions as I have sooo many!! Do you have much psoriasis?

I've still got to have ultrasound of my enthesitis to confirm how many sites etc before I get more than NSAIDs. They are trying to work out how much is back and hip pain from the fracture and funny shaped hip and how much is the spondylarthropathy (though I reckon they are all connected - think my hip ended up a funnny shape because of the enthesitis but they just hmmm at me when i suggest that)

Are DMARDS the normal treatment? Sorry you have had to try them all. I'm like you though I have very little swelling and the enthesitis does seem to be the worst thing. It drives me mad mornings and evenings - do you have any tips?

Thanks

Kit

dorcas

Hi Kit!

I too have PsA and at times have enthesitis (shoulders)and bursitis (hips)

I was diagnosed 13yrs ago and have gone through various treatments and am currently on my second anti TNF.. Humira plus Mtx, plus painkillers. Also get joint/ IM steroid injections.

The treatment for PsA, in my experience, seems to follow same lines as RA and I've always found the rheummy team very helpful and supportive.

The PsA has affected a number of joints and I have had surgery on elbows, back, L wrist (fusion) and will be having a total wrist replacement of the other wrist this year.

I don't have psoriasis, so it took a year to diagnose (not as long as you had to wait!), although there is a history of psoriasis in the family.

I agree that enthesitis is very painful!.... steroid injections help and applying hot packs too can give some relief..
I had acupuncture for bursitis in the hip last year and that actually worked really well!

The forum is a great place to share your 'ups and downs' so feel free to ask any questions you might have...there's always someone around who is happy to respond or just offer support. Iris x

dopeykit

Thanks Iris - sorry the arthritis has been so rotten for you. I might try accupuncture for the hip - they took the bursa out and I still have bursitis so am getting a bit desperate with it..

Kit

kmt297

Hi Kit,
I have a tiny patch of psoriasis on my scalp (had it since I was 13) but it has completely gone with MTX (also a treatment for psoriasis as well as arthritis). DMARD's seem to be the next step if NSAID's don't settle things but the 1st Dr I saw recognised spinal involvement in PSA and told me they needed to take an aggressive approach. Well the PSA is now very aggressive (or at least it feels like it) so I'm glad. Very tired this week as I had a steroid injection several weeks ago and it's wearing off. Fatigue is a major issue for me along with back pain. The rest I can usually cope with but I had costochondritis (inflamm of rib joints) a while ago which was frightening as well as painful as I couldn't breathe! Hope you're having a good day...
KT