Psoriatic Arthritis

Molly28

Hi everyone. I had my follow up rheumatology appointment yesterday and feeling confused. Last time he suggested my issues being psoriatic arthritis. I was given a general steroid injection and it worked wonders. Yesterday he changed the diagnosis to arthralgia. He acknowledged that the steroid injection would only work if there was some inflammation but said because my blood results don’t show inflammation and, after an ultrasound on my hands, I’ve not got inflammation. My hands aren’t the only place with pain. It’s in my toes, right knee and lower back too. He saw my nails, which are horrible looking, discoloured and lifting in some places with pitting and ridges; he said he could see this. He dismissed the chunky swollen fingers, dismissed the rash on my elbows, dismissed the eye pain, swelling and redness (said to go to the optician) and dismissed the loss of strength I have. I have bowel incontinence and blood in stool but getting a colonoscopy soon. Thankfully he’s given me a DMARD to try but I feel he may be overlooking the real issue by giving a diagnosis of arthralgia. I’ve had to call in sick at work, which I’m upset about. Anyone experienced this. He’s the professional so I have to trust him but I can’t help thinking maybe he doesn’t know as much about the link between joint pain, nail conditions and eye problems etc.

Thanks for reading.

Loggiemod

Hello @Molly28 could you get another opinion from your GP or a different consultant?

Might be worth watching the videos in teh following to see if that sheds any light on it

https://www.versusarthritis.org/news/2022/may/all-about-psoriatic-arthritis/

Hope you get sorted soon

Peter

jamieA

https://community.versusarthritis.org/discussion/58502/psoriatic-arthritis

Hi @Molly28

I'd agree with @Loggiemod that you should ask for a 2nd opinion. I was diagnosed with PsA in October 2020 based on my condition at the time - repeatedly swollen knee and hands - but primarily the fact I came from a family of psoriasis sufferers - including myself. As the hospital where my rheumatology clinic is doesn't have an admissions department every time I was admitted to hospital it was another hospital and so I didn't see my rheumatologist. I think I've seen probably about 10 different rheumatologists and have had a number of different opinions as to what was wrong with me. They've included arthralgia, arthropathy, polymyalgia rheumatica, gout, pseudogout, trigger finger, osteoarthritis, carpal tunnel and psoriatic arthritis. I've accepted this as there seems to be no definitive test for PsA - no RF or anti-CCP blood test equivalent. I've read here and elsewhere there is a term seronegative describing people whose blood tests do not detect the presence of the disease.

In my case my first rheumatologist didn't seem to care so I asked my GP to request a change of consultant and I followed up with a letter to my consultant basically stating if he wasn't prepared to help me then to transfer me to another consultant. I'm now with another consultant who seems far more helpful.

I've read up a lot on PsA since I was diagnosed and I've got to say that your symptoms seem to far more match it than mine do. In my case I didn't get any relief from DMARDS and steroid injections and tablets were the only thing that worked until I was put on biologics last year and I'm stable now.