Psor Arthritis - How does the doc know?

[G.J.]

I've made an appointment with a Rheum to check out my sore hips (for about one year now). My question is... in all my research I cannot find a difinitive test that can positively identify if you have PA. Sure I've got ongoing pain and plaque psor, but I certainly am uncomfortable with meds if it's just old age (ha, I'm 43). Anyway, any answers prior to my doc visit 9/28 would help.
Gail

[gaymurphy]

My understanding of diagnosing pa is that a doctor eliminates rhumatoid arthritis, and uses external symptoms to decide if it is pa. My orthapedic (sic) X-rayed hips and found definite damage, plus other joint involvement. Whatever type you have you should seek treatment, so that more damage isn;t done. I have had pa for 35+ years, starting with feet, hips , everything. I have had both hips replaced, a sodsend as far as quality of life is concerned. I am female, 57 yrs old. Good luck, I hope you like your doctor.

[Kirk]

well a lot of it i think is susipcion that it might be PA then ruling out other things by blood tests and then it by default is called PA. Anyone know better?

[Lorna]

Psoriatic arthritis typically affects the distal joints of the hands and feet as well as other joints. As far as lab work, a rheumatoid factor is usually negative. Your doctor may also look at family history to arrive at a diagnosis.

[web63]

The PA also effects the tendons at the joints. You will ussually not just have joint pain, but sometimes,... almost a shooting pain, like maybe, from the hip towards the knee.
Mine started in my hips, about 2 years ago, even with aggressive treatment, it has spread. Hips, knees, ankles, shoulders, elbows, wrists, and beginning in my fingers.
I am on: Azulfidine, Folic Acid, Prednisone, Methotrexate shots (MTX), and Remicade infusions every 6 weeks.
I am now out of work for 9 weeks on FMLA.I told my Rheumy how bad I was doing, and he said "What the HE$$ are you still doing at work?"
Well, the next thing you know he is writing me an excuse that I took over to HR, and BOOM!! I am off for the next 9 weeks.

SO the moral of the story is GET TREATMENT FOR IT NOW!!!!! Before it gets so bad you can't walk.
You can e-mail me personally at pa@web63.com.

Thanks,
Scott in Atlanta, GA

[grandpabear]

I am not sure anyone can accurately determine if one has PA or not. I was told and it was documented over 28 years ago when I was separated from the military that I had PA in both knees. At the time, I was being treated for psoriasis over 98% of my body with methotrexate. Sadly, after 18 years on the drug I developed early signs of liver damage and was taken off of it. While on the drug both my psoriasis and PA were under control. My situation became more complicated in 1995 when I sustained a second injury to my back, this time causing nerve damage radiating through both legs. Now I am being told I do not have PA rather simple arthritis due to scar tissue from the injury. Celebrex does seem to be helpful. I wish I could return to Methotrexate again as I had very little pain or loss of movement while on that medication.

[OS7]

Basically, it's process of elimination. The RH factor is usually negative. Also, not in ALL cases, but in most, there is usually some type of nail involvement. I was told I had leukemia, lymphoma, bone cancer, Chronic Fatigue, Lupus, all in my head, Fibromyalgia, etc....until I visited the Rheumatologist. I did not even know, after 16 years of living with psoriasis, that PA existed. I had never heard of it and NONE of the dermatologists, interns, OB/GYN, etc... I visited ever told me about PA. Only after the oncologist ruled out all types of cancer, was it suggested that I visit a rheumy. When she told me what PA could do, I bawled my eyes out. Sixteen years and not one mention of PA.

Anyway, For the person who was diagnosed with PA and then told they didn't have it, if you used Methotrexate and it worked, AND you have P, AND a previous doctor told you that you had PA, I'd guess you probably have PA. I have several forms of arthritis. It is possible for the forms to coexist. I have osteoarthritis in knees and back, degenerative disc disease in my back and neck, and PA in my feet, toes, knees, hands, shoulders, neck and upper back. I was turned down for disability because I "... still have the use of my hands and feet..."

Go figure...

[redhead]

Hi Gail!
One of the biggest signs your Rheum is going to look for is swollen joints. He will also do blood work and if he is a good Dr will also xray ALL your joints. Amoung other things, the bloodwork gives a SED rate, which I understand tells my Dr. how much swelling I have. Even if the xrays show there is not yet visible damage to your joints, the other parts of the exam can conclude with good probablity if you have PA.

Bad news is = you probably have PA. I am 42 with PA, Plaque and in remission Pustular. If you only hurt after exercise or straining yourself, that would be normal. But with PA you hurt even when you haven't done anything to bring it on. At your/my age you don't hurt all the time, unless you have PA or something. And the pain comes and goes i.e. 'flares up'.

Good news is = if you have so little PA that you are not sure you have it, then you have caught it at an early stage. PA can cause permanent damage to your joints and tendons. The earlier you treat it the better.

I had plaque and pustular for a couple of years before I realized that I probably also had PA. Even though my pustular disabled me, I did not go onto MTX until I started having problems with PA. As much as I hated the idea of MTX and bloodtests and liver biopsy's, I felt it more important to control the PA and avoid permanent deformity and worsening pain. The plus is MTX is also good for treating plaque p.