Hi all. The short version of my story is I was diagnosed with OA in both knees when I was 20. Didn’t want to believe it but got on and accepted it although I’ve alwahs been niggled by the concept of ‘wear and tear’ in a pretty averagely active 20 year old. Next my mum develops arthritis in her hands and has v disfigured fingers. Then my dad develops psoriasis triggered by a hip replacement op. Then I start doing some reading up on PsA and realise that just maybe the stiffness in my fingers when I play the piano and the soreness in my foot when I get up in the morning might signify PsA. Weirdly I hope it is (sorry to those who are really suffering) because I’d rather know and be able to attempt some treatment than be fobbed off by a rheumatologist saying there’s no more they can do for my OA. So that’s my story, now my question… the pain in my foot has quite quickly got much worse so I am now using crutches in the morning until I get going. But because I don’t have a diagnosis I can’t be sure that PsA is the cause. My pain is in the outside of my foot and runs down from my little toe along to the ankle joint and am the stiffness runs across the bottom of my toes but isn’t really in the toe joints themselves. I don’t seem to have the sausage effect that I’ve read about. Do these sound like PsA symptoms to the real experts (the sufferers)?
Hi there JJE239, and welcome!
I completely understand your preference for PsA over OA. I guess OA would in many ways be the least worse possibility, but PsA can indeed be treated effectively and, especially if caught early, the outlook can be pretty good.
We’re only the real experts in a certain sense, the ideal is to find a really good rheumy in addition to support from others who understand exactly what you’re going through. And you certainly sound as if you are suffering to me. Yes, it sounds like it could be PsA, having a family member with psoriasis is a bit of a red flag. I wouldn’t place too much importance on sausage digits though, not everybody with PsA has those.
Next step, I guess, is seeking a referral to rheumatology. It can be, well, less than easy! But make a forceful case for referral to your GP and please let us help in any way we can. I’m in the UK so am all-too familiar with NHS protocols etc., as are many other members.
welcome @JJE239! Definitely you’ll need to see a good rheumatologist. A family history of psoriasis is useful to share with the doctor.
The morning foot pain that you’re describing I’m wondering if it might be tendinitis. Before you think I’m trying to say that means you don’t have PsA, tendinitis can be a big part of it. Hmm. In the states, my daughter started out with an orthopedist who was suspicious over time of her tendinitis, and ultimately got the blood work started as well as a referral to a pediatric rheumatologist. Would it potentially work the same where you are?
Yes get your GP to refer you to a decent experienced in PsA rheumatologist. Given your location it should be easy to find one. A decent one can literally ‘feel’ your PsA too. Your foot pain sounds like my foot pain which can run all along tendon lengths. But truly you just need to be fully checked out by a rheumatologist who knows their stuff, who does the blood tests, the scans and x-rays and a cogent physical examination. Take photos of any swelling too if you get any. The fact you’re having to use crutches in the morning, surely means a referall doesn’t it? Most NHS trusts have a 6 week ‘rapid’ referral to a rheumatologist so get your GP working on it.
Thanks everyone for your support. I do have an appointment with a rheumatologist in Sept. This will be my second appointment in a year. Last time he shrugged his shoulders and said there was nothing to be done with the OA - apparently I’m too young to consider replacements. This was before I knew about PsA. I’ve had blood tests so I know it isn’t RA. I will be much firmer this time and more demanding of answers!
Before being diagnosed w psa had about one year and top clinics in town asserting my problem was uniquely oa, it was through a cancer check up in the end that oncologists referred me to a rheumatological visit, by this time I was on crutches in pain and cortisone shots on my knees had only had little effect. I also had not had swollen fingers nor toes, and no visible psoriasis , but psoriasis in my family. A rheum assessment is essential with expert doctors, to further inspect situation.
Hi @JJE239. Have you had your appointment yet?
(If you don’t want to reply, no probs, but I hope it went well if it has happened already).
Thanks for asking! Yes I had one appointment and the rheumy looked very confused about my symptoms and seemed unsure whether they were all related. At the time, and since, my feet have been the most sore thing and are also showing the signs of psoriasis so he ordered some xrays and ultrasound. I also had more bloods done but I know they won’t show anything. I have another appointment in a couple of weeks but am a bit nervous that I’m going to be left without any helpful diagnosis again. I’ve taken some pretty gross pictures of what I think shows the psoriasis element but it doesn’t really look like the pictures you see on the internet of psoriasis- just peeling skin really. Finger crossed for the next time
JJE – have you been checked for gout? It’s a simple blood test. I ask because you sound much like my little brother. He went round and round with pain in his ankles and knees, was told he had a rare form of arthritis and so on and so forth. Then, in desperation one night while visiting my parents he took one of my dad’s gout pills. PAIN GONE. Because he was in his late 20’s at the time no one had thought to check for gout! He still has some forms of arthritis (I don’t know the details) but he also has gout and that treatment protocol is what really worked for him.
azurelle