I don’t see anything ground-breaking here (though I could easily have missed something new) but I like that it really emphasises the ‘multi-faceted nature’ of PsA. Informative overview of imaging too.
This isn’t earth-shattering news, but it does bring home the complexity of PsA diagnosis, and why doctors are prone to say “Nothing wrong with you that can’t be fixed by exercise and weight loss …” etc. Here’s the line I like:
Plain x-ray films cannot identify inflammation or damage of the ligamentous structures or attachment sites (enthesitis, dactylitis) or reveal small erosions in early disease or bone marrow edema.
So there you go. Your joints are killing you and you ache all over but the doc looks at the plain film x-ray and says “Nothing wrong!”. And then your blood work comes back normal. “Nothing wrong!” says the doctor. Meanwhile, little do you know, but you’ve got enthesitis, dactylitis and bone marrow edema going on but you figure you are just a whining, complaining hypochondriac. That, of course, is something the doctor would agree with.
Exactly, all too true! And of course there’s the other easy explanation … I’m going to have ‘It’s NOT “all OA”!’ tattooed on my forehead. And, while I’m at it: ‘Please check me for co-morbidities’ on my backside. (How to get escorted off the premises by security).
Yes, ditto. Your blood work is fine, nothing appears wrong but we know there is… The body speaks through symptoms. It is subjective knowledge that so happens to be accurate and objective. Doctors have a hard time treating something they cannot see…
Word for word that is what my family dr first said to me for about a year. Until I had to go to a place called the Lockwood clinic in Toronto seeking out a new family dr who then immediately sent me to a rheumatologist.