My 26 year old son had sudden wrist pain, fingers swelled. Went to hand specialist who looked at his history and his ridged fingernails and diagnosed PsA. Gave him meds and cortisone and swelling was done quickly but he still has pain in the hand. He did an ANA, sed rate test and tested for rheum arthritis. Nothing showed up. He does not have carpal tunnel. Sent for MRI, nothing abnormal showed up. Went to another specialist and he is unsure why there is still pain. How do you determine PsA? Are these symptoms in line with PsA?
I'm sorry...that sounds really painful. The swelled fingers can be common but I'm not sure about the wrist. PsA can show up anywhere. Was he diagnosed with Psoriasis ? I know my psoriasis was very little but that didn't seem to matter. I have PsA in my fingers which I originally thought was just an injury. I think it's easy to presume it's something else. I also get pain in my hand right up to my wrist if I'm not taking medication. That constant pain and ache is unbearable. It doesn't come and go on it's own, at least not for me. I had an MRI also, nothing showed up. I think that's because of how different PsA is compared to other diseases.
Not much help but that's my experience so far. I'm sure someone else here who's been diagnosed longer may be able to offer more info. Which meds did they give him ? The cortisone is a relief for the swelling. Had a shot last week myself.
It’s not unusual to have nothing show up in labwork, especially if one is taking steroids. The rheumatoid factor can be normal or slightly elevated in a person with PsA. It can even be elevated in healthy individuals.
While X-ray imaging can be normal in a person who has new onset of PsA, I have been unable to locate any information about whether or not an MRI can have normal results. There has been extensive research with RA with MRI, but not as much with psoriatic arthritis so that might be why I can’t find an answer to that.
One can still have pain without swelling. It is usually related to a condition caused by PsA called enthesitis. This is inflammation of tendons where they attach to the bone.
This website has really good information about how PsA is diagnosed. Keep in mind that everyone is different and that PsA doesn’t always have a typical pattern. Your son’s symptoms seem pretty typical for PsA, but he should be seen by a rheumatologist to confirm that and decide on a treatment plan.
I hope that this information helps you. If you need anything or have any questions, I am happy to help. I don’t mind research! Best of luck to you and your son.
Claire
Hey MOM, It can be confusing for doctors who aren't familiar with PSA. And, unfortunately, they have to run a bunch of test to determine it isn't "something" else before they conclude it's PSA. There is no test for PSA other than visual test. That would include swelling of your fingers, toes. P under ANY of the nails and of course if you already have psoriasis externally on your skin anywhere.
In my case, I didn't and still don't have psoriasis any where other than under my nails. But, I have had psa for over 20 years (I'm 40 now). It is more commonly diagnosed these days and should not be ignored or treated less than severe just because your symptoms are minimal or in remmision.
In my opinion, with what is available today, bios like Enbrel are the only thing that work in slowing the disease and symptoms. The sooner the better. Everything else are meds meant for other diseases that have short term effects on PSA and end up in failure. Then, when you start a bio your symptoms are worse and can only be controled from that point and progressively get worse.
If your son went to the DR in pain and has the symptoms like P under the nails and swelling he more than likely has had minor symptoms/signs of P and/or PSA long before this FLARE-UP. Which means his body is already attacking these areas and he needs to get it under control.
You don't have to read this part it's just a rant...I hate the fact that the insurance Co. try to dictate the series of events that follow a PSA diagnosis. Try this, then this, then this, and when those don't work and your body is already too damaged to keep under control... you can start taking the bios that are made to treat your PSA. Your insurance CAN NOT tell you what meds to takePERIOD! They are not your DR and don't prescibe your meds. TELL YOUR INSURANCE COMPANY "I SEE A SPECIALIST. I HAVE BEEN DIAGNOSED WITH PSA. YOU CAN NOT DICTATE WHAT MEDICATION I TAKE. IF YOU TRY, I WILL CONTACT A LAWYER." See how quickly your pre-authorization gets aproved.
Thank you for this great advice.
Robert said:
Hey MOM, It can be confusing for doctors who aren't familiar with PSA. And, unfortunately, they have to run a bunch of test to determine it isn't "something" else before they conclude it's PSA. There is no test for PSA other than visual test. That would include swelling of your fingers, toes. P under ANY of the nails and of course if you already have psoriasis externally on your skin anywhere.
In my case, I didn't and still don't have psoriasis any where other than under my nails. But, I have had psa for over 20 years (I'm 40 now). It is more commonly diagnosed these days and should not be ignored or treated less than severe just because your symptoms are minimal or in remmision.
In my opinion, with what is available today, bios like Enbrel are the only thing that work in slowing the disease and symptoms. The sooner the better. Everything else are meds meant for other diseases that have short term effects on PSA and end up in failure. Then, when you start a bio your symptoms are worse and can only be controled from that point and progressively get worse.
If your son went to the DR in pain and has the symptoms like P under the nails and swelling he more than likely has had minor symptoms/signs of P and/or PSA long before this FLARE-UP. Which means his body is already attacking these areas and he needs to get it under control.
You don't have to read this part it's just a rant...I hate the fact that the insurance Co. try to dictate the series of events that follow a PSA diagnosis. Try this, then this, then this, and when those don't work and your body is already too damaged to keep under control... you can start taking the bios that are made to treat your PSA. Your insurance CAN NOT tell you what meds to takePERIOD! They are not your DR and don't prescibe your meds. TELL YOUR INSURANCE COMPANY "I SEE A SPECIALIST. I HAVE BEEN DIAGNOSED WITH PSA. YOU CAN NOT DICTATE WHAT MEDICATION I TAKE. IF YOU TRY, I WILL CONTACT A LAWYER." See how quickly your pre-authorization gets aproved.
Wow!! Excellent advice!! Thanks! :-)
mom5932 said:
Thank you for this great advice.
Robert said:Hey MOM, It can be confusing for doctors who aren't familiar with PSA. And, unfortunately, they have to run a bunch of test to determine it isn't "something" else before they conclude it's PSA. There is no test for PSA other than visual test. That would include swelling of your fingers, toes. P under ANY of the nails and of course if you already have psoriasis externally on your skin anywhere.
In my case, I didn't and still don't have psoriasis any where other than under my nails. But, I have had psa for over 20 years (I'm 40 now). It is more commonly diagnosed these days and should not be ignored or treated less than severe just because your symptoms are minimal or in remmision.
In my opinion, with what is available today, bios like Enbrel are the only thing that work in slowing the disease and symptoms. The sooner the better. Everything else are meds meant for other diseases that have short term effects on PSA and end up in failure. Then, when you start a bio your symptoms are worse and can only be controled from that point and progressively get worse.
If your son went to the DR in pain and has the symptoms like P under the nails and swelling he more than likely has had minor symptoms/signs of P and/or PSA long before this FLARE-UP. Which means his body is already attacking these areas and he needs to get it under control.
You don't have to read this part it's just a rant...I hate the fact that the insurance Co. try to dictate the series of events that follow a PSA diagnosis. Try this, then this, then this, and when those don't work and your body is already too damaged to keep under control... you can start taking the bios that are made to treat your PSA. Your insurance CAN NOT tell you what meds to takePERIOD! They are not your DR and don't prescibe your meds. TELL YOUR INSURANCE COMPANY "I SEE A SPECIALIST. I HAVE BEEN DIAGNOSED WITH PSA. YOU CAN NOT DICTATE WHAT MEDICATION I TAKE. IF YOU TRY, I WILL CONTACT A LAWYER." See how quickly your pre-authorization gets aproved.
Actually "State Insurance Commissioner" is more appropriate (and effective) than lawyer The instant you threaten litigation they have the right to say no more or take no further action forcing litigation. They have hundreds of lawyers on staff. Also if you read your policy you have waived the right to litigation until the "appeals process and arbitration process is exhausted.
In a very strange way they actually CAN dictate a lot if you have a prescription rider. Its covered in the fine print of your policy.
That's for the lawyer to handle...Fortunately, When I told my insurance company I was not going to try a handful of asprin for my psa that, I was going straight to enbrel and they could shove it, they approved my pre-authorization in less than 48hrs! That happened when I was first diagnosed and also, a year ago with my new insurance.
Unless, your insurance states they don't cover a certain drug on your policy at all, they can't dictate what treatment you recieve. Only what they actually cover under your policy, the amount they pay, and, where you get it. They want you to beleive that you have to try cheaper meds first but, you don't.
tntlamb said:
Actually "State Insurance Commissioner" is more appropriate (and effective) than lawyer The instant you threaten litigation they have the right to say no more or take no further action forcing litigation. They have hundreds of lawyers on staff. Also if you read your policy you have waived the right to litigation until the "appeals process and arbitration process is exhausted.
In a very strange way they actually CAN dictate a lot if you have a prescription rider. Its covered in the fine print of your policy.