I am currently in the process of finding out for sure if I have PSA or not. I have had severe low back tightness and pain for well over a year. Also several toes hurt quite often for weeks on end. I get tendonitis's constantly and with little cause. I have fingernails that constantly get the loosening from the nail bed. But they also tend to grow out to almost normal appearance in between although the nurse practitioner I see has seen them at their worst. I have also lost the same toenail twice for no known reason.
So my question is, has anybody else had repeated labs drawn and had the one for generalized inflammatory response be normal? My lab for rheumatoid arthritis has been normal. I don't have any known psoriasis and like I said above, my nail abnormalities tend to come and go.
Another point of interest is that I have been taking Lyrica for several years to quell some abnormal itching of my arms, probably due to a past spinal cord injury. The Lyrica takes care of that well but does nothing for what ever type of arthritis I must have. Xrays have shown only age appropriate arthritic changes in my back. But since I am a x-ray tech, I know that means little. What is age appropriate after all? But if my issue was osteoarthritis then the Lyrica should have helped. I also try to do gentle stretching every day and even tho it helps, it never seems to loosen my muscles up at all. Bouncing gently on the yoga ball in the morning is the only thing that helps even a little.
I would love to have a final diagnosis, either way. The nurse I am forced to see by my insurance is slow to refer patients out for anything. If I have PSA, then so be it. I would love an answer to why I hurt and why I am tired all the time when I should not be. If it is another type of arthritis then she needs to help me out cause I can not easily take over the counter anti-inflammatories due to having a touchy tummy.
I've been diagnosed with PsA and my labs show very low inflammation, but I had sever pain in my feet and now my lower back, butt and hips. Also, I'm very fatigued.
My labs 3 years ago were slightly abnormal and neg rheumatoid but the last 2 years have all been normal apart from very abnormal liver function on one occassion which on last test had returned to normal. Rheumy still diagnosed PsA - apparently bloods are normal in 50% of PsA suffers
I always have negative labs for inflammation every time they are taken and was just diagnosed with PsA last week. It must be common, but certainly makes the diagnosis take longer.
Always have had negative labs. I have lost toenails and they are still a problem despite Enbrel and prednisone dampening the overall effects of the PSA. While some areas like my lower back knees and some finger joints show bone erosion other areas that are extremely painful show only tendon inflammation and no bone problems.
According to the CASPAR criteria for PsA, negative RA factor, dactylitis and nail lesions IS considered 1 point towards diagnosing PsA. Some studies show that only 50% of us have an increased SED rate (I.e., inflammation). The book that Seenie recommended by Chadran and Gladman is very good and has all this information. Why the first 3 Rhuemys that I saw don’t know this information is perplexing to say the least. Or why they don’t share it? The book is only 10.00 and is called Psoriatic Arthritis- The Facts
My inflammation marker are positive but mildly so. Actually it amazes me that after being on meds for 6 months I thought they would become normal. But sadly it hasn’t. I suspect we will change meds when I see the rhumey next week.
I've had pain and inflammation for over 7 months. Xrays are neg for joint damage. Blood is neg for rheumatoid factor. I did labs again last week and sed rate is 9. I still have pain and swelling in 20 joints (toes, fingers). I took prednisone for 3 months and that didn't help. I've been on mtx for 3 months and not only has it not helped, but it seems to be getting worse. I don't have any rash, skin, or nail problems. Sometimes I wonder if I have the right diagnosis. Will see rheumy tomorrow.
Keep us up to date Spammy. You mentioned fingers and toes only. Just wondering. . . Could it be erosive osteo? Will they redo x-rays to compare from seven months ago?
I'm still doubtful of my PsA diagnosis. My bloods always show low inflammation and I am HLA B27 positive.
My Rheumy diagnosed PsA and mentioned terms such as enthesitis and spondyloarthropathy. I am still not sure about the diagnosis, have never had a joint xray and most days try and take no medication for aches and pains as I usually can cope without them.
I went years without diagnosis due to negative labs. I finally saw a rheumatologist - went in with hugely inflamed joints - and still my labs were negative for inflammation. That actually helped me get my diagnosis.
I want to thank everyone for their input. I see my NP this week for a yearly physical and I am going to try and steer her gently, or even a bit sternly, to refer me out to a rheumatologist for a further work-up. When I had my physical last year, I had a different nurse practitioner and she was actually the first to suggest PSA. I have a walking partner who is a recently retired internal medicine specialist who, as a friend, has also suggested PSA based on my fingernails at their worst. My feeling is, that if you suspect it, then send me to someone who can help make the diagnosis and go from there. I am a bit tired of everybody telling me that this is all just old age and that I should accept it. If they had my back every morning, and if they had as much trouble going to sleep at night, then they might feel otherwise. But no one else can walk in my shoes and I have to also accept that, and know that only I can affect my health care. If I am not my own advocate that I will get what I deserve. My Dh is horrible about all of this. But I still love him!!
My first doctor said that all this is in my head, because my lab test were normal. I did so much research about the condition, because I was tired of my doc telling me that I just have to move more, eat better, exercise, stop thinking, consider antidepressants, etc... I guess having psoriasis will help the doctors to diagnose the condition, but try to get someone who has experience and compassion. And don't gave up. You have the right to know what is going on in your joints.
My inflammation markers have only ever been slightly elevated. Doc suggested at one point that if I were to lose weight, they would probably go down. This was at the same time that I was complaining about sore feet, and extremely tired for no apparent reason. And now that you mention it, Nicole, I got an antibiotic for my big toe “infection” as well. (Different doc, many years ago.)
Have you seen a dermatologist about your nails? That might provide some direction to the diagnostic process.
And finally, has your doc done a prednisone trial to see if that alleviates the sore toes and tendinitis? If the prednisone helps, that would confirm that you have an inflammatory condition. The first rheumatologist I saw suggested this and it was very informative.
My first doctor said that all this is in my head, because my lab test were normal… I was tired of my doc telling me that I just have to move more, eat better, exercise, stop thinking, consider antidepressants, etc…
I saw the rheumy. He said he's never had a patient that didn't respond to mtx. I asked if I really have PsA and he said yes without hesitation. Doesn't sound like he'll do more xrays in the near future. He increased mtx to 8 pills. He said to add a biologic later and stay at 8 pills.
I'm holding off on the biologic because if the mtx is able to control the disease by itself, that's less meds for me to take. Well, I'm also a terrible patient when it comes to needles. That's another reason I'm holding off on the biologics. After being in pain for so long, I am not looking forward to adding the needle pain, too. I know if it helps control the inflammation and pain, I won't have much pain except for the needle each week.
I'm also afraid I'll have an allergic reaction to the injection. I have allergic reactions to the TB test every year and cannot get a flu shot again due to an allergic reaction. Did I mention my aspirin, ibuprofen, and naproxen allergies? Ugh...I'm a mess. Thanks for your concern, Stoney. :)
Stoney said:
Keep us up to date Spammy. You mentioned fingers and toes only. Just wondering. . . Could it be erosive osteo? Will they redo x-rays to compare from seven months ago?
Hi,
I was diagnosed 20 years after first starting symptoms and had severe Psoriasis…tendon problems especially wrists and ankles from my early 20s. All blood tests came back normal, my official diagnosis now is inflammatory sero-negative arthropathy.
I do believe if I had bone erosions from early on it would have been diagnosed earlier but I see it as lucky that it was just tendon involvement during those 20 years or so, who cared if it had a name, at least ot was mild enough for me to get on with my life.
I can fully endorse the book mentioned earlier in the replies
Spammy said, "I saw the rheumy. He said he's never had a patient that didn't respond to mtx."
I didn't respond to MTX. But my rheumy didn't see this as an issue, and after 6 months switched me over to leflunomide. There has been a study done showing that leflunomide alone works better for PsA than MTX alone, so I don't know why your doctor would say that.
