What tests to diagnose PA

[aysha01]

Hello

Another question..can someone tell me what tests can a doctor do to diagnose PA. See a rheum. in 8 weeks. Would like to be able to see the rheum. with something in hand to try and get some answers sooner.

thanks
Aysha

[MikeK]

Hi Aysha,

I don't think that we've met, so let me take this opportunity to welcome you to the Board. :cool: Nice to meet you.

PA can be very hard to diagnose. That's because there's no specific test for it. People sometimes go for years and from doctor to doctor before they finally get a proper diagnosis. Don't be afraid to ask for a second or even a third opinion.

Even thought there's no specific test for PA, I'm going to give you a link to a "must read" post by JesseLou. She discusses the tests that must be ordered and the questions that must be asked whenever PA is suspected. Here's the link to her post: http://www.psoriasis.org/forum/showthread.php?p=74786&highlight=question#post74786.

I hope this helps.

Good luck! Keep us posted. Let us know if you have any other questions.

Mike

[alison149]

hi Aysha, I was diagnosed with PA on my first rheumatologist appt. You could say I was one of the lucky ones !!! yeh right. My gp had already tested me for RA and it was negative so he sent me to the rheumy. My pains etc were bought on by trauma and I have a family history of psoriasis (mum - pustular and aunt - guttate) . all my tender joints were checked for fibromyalgia and every joint was checked. that same day i had a full body bone scan and went back to rheumy . that was how I was diagnosed. with the fact I also had high sed rate and crp. Hope this helps somehow.

[princesstwinsmom]

I was diagnosed because my sed rate was elevated on a routine blood panel and the RA and lupus scans came back negative. My GP didn't have a clue, so he sent me to a rheumy. She diagnosed me on my first visit based on documented history from my GP and physical examination. At that first visit, they did baseline hand and feet x-rays, but no further radiologic tests.

[easydoesit]

My primary care doctor ran bloodwork on me including a sed rate test, and some other inflammatary tests (I think the RA bloodtest was one of them). From what I understand all of my bloodwork was completely normal and I was sent to the rheumatologist.

When I saw my rheumatologist he took one look at me and my hands and "yup, psoriatic arthritis." I think in my case it was pretty simple because I also have the classic nail pitting and obvious spots of psoriasis on my hands and elsewhere.

[ouchyk]

Odd woman out with a positive RF...but dx with PA none the less.

A very small % will have a positive RF in a low titer for some unknown reason...and I'm thankful as I would have never been sent to a rheum by my PCP and still wondering how I broke my wrist in my sleep.

Also had elevated sed rate, hot red swollen joints, typical nail involvement.

Although there is no single " test " there are indicators of active disease, a good rheumatologist should be able to tell.

Good luck to you.

Karen

[JesseLou]

I'd like to add that it's not necessary to have nail, hand, or foot involvement in order to have a positive PA diagnosis - I never have had.

[docmks]

Hi Aysha, Welcome to the PA boards. Most of my blood tests that people referred to here have been negative. I seldom have had an elevated SED rate or C reactive protein. I had a positive Rheumatoid factor once but they didn't make much of it because my SED was low. However, once you get started on meds, the medications can affect the tests by lowering your immune response. So, once meds are started you are less likely to get high SEDS and such. My nails are usually not too bad. My toenails are looking a littled ridged and pitted lately, but as JesseLous said this is not essential to getting diagnosed with PA.

Take care and let us knowhow you are doing
MK

[ouchyk]

nails are involved in around 80% percent. I had classic pitting.

Here are some tests that the rheumatologist might want to run to rule out/in other diseases;

C-reactive Protein
Rheumatoid Factor
Antinuclear Antibody (ANA)
Uric Acid Test
Erythrocyte Sedimentation Rate (ESR)

I've tested positive for RF a few times, re-testing is sometimes done as there are false ~ negatives and a dx is in question.

But bloodwork is a small part of the puzzle as many don't test positive for anything and as you can see nails are not involved in everyone...

and some folks have nail involvement with NO PA!

Karen