My Dermie said the newer specialized ultrasound is the best machine now for DX of PsA.on the digits.I am sure some Docs would balk at that especially if they have not read the latest literature or it might mean additional financial outlay for new equipment.
As far as Xrays .I had way too many that were always read as "moderate arthritis" until I was in surgery and heard the Orthopoedic Surgeon tell the Anesthesiologist the reason he was having trouble getting the needle into my spine was because it was,
"..... really full of arthritis.in the spine" So for over a decade I was thinking perhaps I was crazy or a hypchondriac complaining about my groin pain ,achilles tendonitis ,shin splint ,neck and shoulder pains and parasthesia of legs and right arm.Oh and yes i thought for sure I was a cardiac case due to the sausage digits that would swell for no reason! The MRI report was where i believe he ( the surgeon) discovered the extent of my arthritis.Now they tell me the nerves in the spine are being pinched and causing the painful muscle spasms in my back and neck.
I am not on any Biologics , just pain meds prn . Am sure the Biologics will be coming this way once i go and have definitive PsA DX ...already am seeing the end of my thumb begin to deform along with the index fingers on both hands.......
'Everybody has a touch of arthritis " is what my GP always said. Then one of my patient's asked me if anyone ever noticed that i drag my right leg!......When the hip started to lock was when I really got frightened and then I did some research and went over the Bridge into Philadelphia. Rothman Orthopedics was the first place that Xrayed me standing up.They did an MRI also and told me I was fill of gallstones too........as far as Xrays are concerned...vital organs or not too much is not good. husband was Xrayed every six moths by his Dentist growing up and now when any tooth needs extraction the Dentist gets very nervous because they tend to shatter when gripped by the dental instruments. The Dentist told him this was the result of being over Xrayed as a child.. I always ask now if there is another diagnostic test that can be done instead of Xrays but of course many times you have to get what is prescribed. Better to really have a good discussion with your Physician rather than staying silent.Explain concerns and ask about types of other testing .
I'd still like to know about the PREDNISONE. Would it be typical for a person with PsA to have a good response to prednisone? I was pain free on 40mg and started my taper to 30mg yesterday and I am starting to feel stiffness and pain already. From what I understand, steroids are not a mainstay for Psoriatic Arthritis, but CAN it sometimes help? My internist is now saying I have an INFLAMMATORY ARTHRITIS due to my positive reaction to prednisone, but I am not categorized as having PsA.
Prednisone and other systemic steroids reduce inflammation. Problem is they are hard on the body and not a long term solution. I have worked in healthcare for many years and have seen many doctors use steroids for pain relief.
YES, it would be typical to have a positive response to Prednisone. When the Docs were first trying to figure out what was wrong with me, their first thought was Fibromyalgia but when I had a positive response to Prednisone it was an AhHa moment. But Prednisone is used for a lot of Rheumatological diseases and my next diagnosis was Polymyalgia Rheumatica (say that 10 times fast!). I thought that first shot of prednisone was a miracle but it didn't last forever and then it took almost 2 years to wean off the pills. It took 5 months and 2 Rheumys to finally diagnose me with PsA.
Inflammatory Arthritis refers to the many autoimmune conditions. Do you have Psoriasis?
I've had the burning...it started before I realized I had PsA. I guess it was one of the first symptoms. Still get it sometimes...never get used to it.
I have seen first hand of a lady with RA, who is in her 70’s, who was treated with steroids exclusively with steroids and had both of her legs amputated because of the long term use of steroids. She tells me every time I see her, how she is glad there are better treatments avaiable for RA patients now.
Thank you Honey. I have severe lung disease and was hospitalized with pneumonia. That's why they put me on prednisone. I feel like the lung disease is tied into this arthritis somehow, but I'm not sure. I started my taper to 30mg and am already going downhill. I understand prednisone is a double edged sword. It can save your life and it can kill you.
Interesting. My internist and orthopedist thought I might have Polymyalgia Rheumatica but decided not. I was on prednisone while in the hospital with pneumonia. They tried to pull the plug on prednisone without a taper and I felt I was dying. My endocrinologist said my adrenals didn't wake up and they put me in grave danger. I already knew that as I felt I was dying. My internist disagrees with that (he thinks he's an endo, I guess) and said I should have no problem with stopping it or tapering it by 10 mg per week. I already know what will happen and I'm not being negative; I'm a realist.
I have nail pitting, ridging, discoloration, loose nails and have lost finger and toenails. Always painless. One ear is red, crusty and flaky; even inside the ear canal. Internist thinks it's Eczema and told me to put OTC cortisone cream inside the ear. I have an upcoming dermatology consult and I'm not going to mask it with the cortisone before I see her.
westee said:
WW:
YES, it would be typical to have a positive response to Prednisone. When the Docs were first trying to figure out what was wrong with me, their first thought was Fibromyalgia but when I had a positive response to Prednisone it was an AhHa moment. But Prednisone is used for a lot of Rheumatological diseases and my next diagnosis was Polymyalgia Rheumatica (say that 10 times fast!). I thought that first shot of prednisone was a miracle but it didn't last forever and then it took almost 2 years to wean off the pills. It took 5 months and 2 Rheumys to finally diagnose me with PsA.
Inflammatory Arthritis refers to the many autoimmune conditions. Do you have Psoriasis?
All arhritis is the result of inflammation.Trying to pin down the exact cause of a flare has been a lesson in futility for me. Damp cold weather changes are classic and why so many seek out the warm dryer climates as they age. The kicker is when I get sick and run a low grade fever.The anti inflammatories knock down the fever and until I get a cough or a sore throat I just think i am having another arthritic flare.
This has been a most puzzeling diease and the medications and their side effects seem to only add to the puzzle for a search for relief.I have no skin psoriasis but do have the classic nail pitting.
I have been trying every natural remedy known to man. Deep water exercises with an aqua belt and gloves has been the best thing I have found to stave off the stiffness.Low dose Vicodin for the severe attacks of pain and muscle spasms. Too many hot targeted showers that feel oooh so good have dried out the skin and cause annoying itches. i miss a deep long restful sleep the most. Can never stay asleep longer than three hour sprints. The pain and pressure always wake me up.I long for the mornings again when the bed feels so confortable i do not want to get up. now I have to because when consciousness returns from sleep it beings the pain and stiffness with it.
My PsA started with an terrible "aching" in my hands... The more I used them- the worse it got ( ie. cutting vegetables, laundry, squeezing out the kitchen dish cloth a lot etc.). Slowly it advanced, but for me it was the first symptom. X-rays came back normal. But as others have shared- inflammation does not show up on x-rays. The Naproxen, combined with methotrexate has really helped with the chronic inflammation. Enthesitis is the part of the disease where the tendons flare- specifically at the insertion of tendon to bone. For me- this part of the disease is more prominent than the joint damage...
I can relate to everything you said. I also take Vicodin. Amytriptaline, Cymbalta, Neurontin, and Plaquenil to try to keep the pain to a dull roar. I take it in vain as it really does nothing for the pain but I guess it makes me feel like I'm trying to be proactive and do something about it. Pain and pressure so familiar. Muscle spasms are very painful, especially in ribs and toes. Toes are twisted in odd positions now. I'm so sorry for us. For anyone with "this." Puzzling for sure. Can drive one insane.
The aching in my hands is sooooo familiar. Not arthritis type pain, but deep aching from muscle? ligament? It also was one of my first symptoms after having strep throat. I can't take anti-inflammatory medications as I have Barrett's Esophagus (pre-cancer) in my throat.
Can someone explain Enthesitis to me? Or provide a good link, possibly with visuals? I am intrigued by it. Could my "joint" pain actually be Enthesitis? Thank you for posting this.
WIth appreciation,
Victoria
Cocoloco53 said:
My PsA started with an terrible "aching" in my hands... The more I used them- the worse it got ( ie. cutting vegetables, laundry, squeezing out the kitchen dish cloth a lot etc.). Slowly it advanced, but for me it was the first symptom. X-rays came back normal. But as others have shared- inflammation does not show up on x-rays. The Naproxen, combined with methotrexate has really helped with the chronic inflammation. Enthesitis is the part of the disease where the tendons flare- specifically at the insertion of tendon to bone. For me- this part of the disease is more prominent than the joint damage...
For the record, mine too started after a serious throat and pneumonia type illness. Turned out to be lyme disease. Took them a year and a half to figure that out and now I can't get well, even after a year and a half of antibiotics, antifungals etc. Might want to look into that possibility. I've heard of ppl getting salmonella and a year later getting RA so bad they were disabled. Did you know that Michael J Fox had lyme? Then a year later got parkinson's. There's usually a viral connection if you test negative for everything. I'm negative even on the genetic tests... my CD 57 cells were at 24. Typical for lyme. BTW- 200 is normal, under 60 is very ill. 22 is usually critical. A lot of ppl have lyme and don't know it. It's not just ticks spreading it now, they've found and not just in the woods. They've found it in mice, fleas, prairie voles. Worth considering, anyway.
Awesome. But sorry for the mystery issues. I feel ya. I had lyme and babs. It's made my life hell for 7.5 years now. Sigh. I'm still degenerating no matter what I try, so hopefully I'll have some direction by the end of the month after allergy scratch tests and first visit with rheumy since I came back stateside. I call myself "mystery meat." ugh. Best of luck in your direction too.
I have planters fasciitis which feels like burning in my feet. I've also experienced the same feeling behind my knees. one my bone scan they found bone erosion on my feet. I would say an xray would show damage not be a deciding factor though. Good luck.