New to PA

Jayneyb

Hi
I was hoping for some advice. I have had mild psoriasis for 30+ years. Finally seen a rheumatologist after 10 months of joint pain and nail psoriasis. I am in a lot of pain with my hands, feet and lower back. My blood tests showed no inflammation which I believe is not always uncommon with PA? The consultant says I have psoriasis in my tendons but due to lack of inflammation doesn't want to start treatment for PA?surely psoriasis in the tendons is PA? My psoriasis tends to go in 6 year cycles and is quite bad at the moment. Any advice? I am seeing the consultant again in 3 months after I have seen a dermatologist. What should I be asking for?
Thanks for any advice.

helpline_team

Thank you for getting in touch with Helplines. I’m sorry to learn that you’re experiencing pain in the hands, feet and lower back, and that you’ve waited 10 months to see the rheumatologist.

Psoriatic arthritis is one of the types of arthritis known as ‘spondyloarthropathies.’ What these types of arthritis have in common are:

• certain symptoms (e.g. inflammation in different joints, lower back pain and stiffness)
• a lack of antibodies in the blood, which means that the blood tests which usually get a positive result in the diagnosis of rheumatoid arthritis come back negative for spondyloarthropathies.

Inflammation levels may also appear normal in blood tests. This means that psoriatic arthritis can be difficult and time-consuming to diagnose. The following Arthritis Care factsheets give more information:

https://www.arthritiscare.org.uk/assets/000/001/119/PsoriaticFactsheet2015_original.pdf?1441983736

https://www.arthritiscare.org.uk/assets/000/001/230/SpondyloarthritisFactsheet2015_original.pdf?1446046129

Psoriatic arthritis would usually be diagnosed by assessing your symptoms over time and sometimes blood tests to rule out other types of arthritis. As your next appointment with the rheumatologist is 3 months away, it may be worth telephoning the rheumatology department’s helpline or specialist nurse to discuss the outcome of your last appointment. Hopefully, they will explain a bit more about the reasons why you are not being treated for PsA at this stage.

You mention that your dermatologist appointment will come first. It may help to know that one of the drugs that can be used to treat severe psoriasis – Methotrexate – is also a drug that can be used to treat psoriatic arthritis. It may be worth discussing this possibility with your dermatologist.

If it would help to talk over any of these things, I hope you will call the Arthritis Care Helpline (0808 800 4050).

Best wishes,

Rachael, Helplines Worker