Hi all, my flares recently have been in my lower back/hips areas. Got my first “sausage” finger in April, and now my index finger 5 days ago. I can’t completely stand up straight today and feels like my rt hip is in a vice. How do you know if this is spondylitis or or PsA? So frustrating waiting to get the diagnosis 2 doctors have already told me I have. And 1 more question. When I see the Rhuemy will he be able to diagnose me correctly if no flares or swelling at the time?
Thanks to all for your help,
Hi Michelle, I'm no expert by any stretch, however I'm absorbing as much info as I can every single day. Some people don't really care to know what's going on with their bodies (have an uncle like that), some of us (ME) fall into the category of persons who want to know everything about what our bodies are doing and why!
When I first saw my Rheumatologist he seemed to be on the fence of whether I had Anklosing Spodilitis or Psoriatic Arthritis. Basically it came down to the psoriasis on each side of my nose and spots on my scalp which lend to the diagnosis of PsA that's affecting my spine. One statement that he made at the appointment stood out. He stated that the treatment for both is the same.
Hope that this info. helps. I'm a Christian so instead of wishing you good luck, I prefer to say "God's Blessings"!
Michelle, take a picture of your finger and take it with you to the appt. That is the best thing I did because I am never swollen when I have a rheumy appt.
Keep us informed. Take care!
I have PsA AND AS - there are some person who get PsA with spondylitis.
I second taking photos of sausage digits and swelling when you have them.
Here's more info from http://www.psoriasis.org/psoriatic-arthritis/types
Types of Psoriatic Arthritis
There are five types of psoriatic arthritis: symmetric, asymmetric, distal interphalangeal predominant (DIP), spondylitis and arthritis mutilans.
Symmetric arthritis is much like rheumatoid arthritis but generally milder with less deformity. It usually affects multiple symmetric pairs of joints (occurs in the same joints on both sides of the body) and can be disabling.
Asymmetric arthritis can involve a few or many joints and does not occur in the same joints on both sides of the body. It can affect any joint, such as the knee, hip, ankle or wrist. The hands and feet may have enlarged "sausage" digits. The joints may also be warm, tender and red. Individuals may experience periodic joint pain which is usually responsive to medical therapy. This form is generally mild, although some people might develop disabling disease.
Distal interphalangeal predominant (DIP) although the "classic" type, occurs in only about 5 percent of people with psoriatic arthritis. Primarily, it involves the distal joints of the fingers and toes (the joint closest to the nail). Sometimes it is confused with osteoarthritis, but nail changes are usually prominent.
Spondylitis is inflammation of the spinal column. In about 5 percent of individuals with psoriatic arthritis, spondylitis is the predominant symptom. Inflammation with stiffness of the neck, lower back, sacroiliac or spinal vertebrae are common symptoms in a larger number of patients, making motion painful and difficult. Peripheral disease can be present in the hands, arms, hips, legs and feet.
Arthritis mutilans is a severe, deforming and destructive arthritis that affects fewer than 5 percent of people with psoriatic arthritis. It principally affects the small joints of the hands and feet, though there is frequently associated neck or lower back pain.
Spondy is a 'type' of PsA, the type that goes after the spine, and SI joints are often our first indication. Only your Rheumatologist can give you the 'for sure diagnosis' that you are looking for, not only through his vast education and experience, but also through tests, such as a simple x-ray of the affected area.
I am a Spondy, so I understand how you are feeling, and I surely hope that you will very soon be given a treatment that can really improve all areas of your life.
Hugs to you,
It might be both - I have spondilitis and PsA- my spondy might get re-DX to anklosing if it continues progressing- it,doesn’t matter which it is - the treatments are pretty much the same- MTX a biologic and NSAIDS.
I have PsA of type Spondylitis. It is a type of PsA. About 10% of people with P get PsA, out of that 10%, about 5% get PsA of type Spondylitis. Unfortunately, it is the second worst type of PsA (note: no type is desirable). The Worst type Arthritis Mutilans. Fortunately I don't have that.
I am being treated with Enbrel. It seams to take a lot of the pain away in my hands and the pain in my neck, shoulders, hips, lower back and feet don't seam to be as severe. I still have a lot of fatigue though.
What Joel said! PsA has different subtypes (five I believe) which can happen individually or have overlap. I have the common variety (primarily effects hands, feet, knees and elbows on both sides) and it evolved to include the spondylitis/sacroilliitis type about seven years after the initial diagnosis (back, lower back and hips). Not everyone has PsA in their backs though.
It seems confusing but this is how it was explained to me: Spondylitis means inflammation in your spine, it’s not a diagnosis, it’s a symptom. Sacroilliitis is inflammation in your sacroilliac joints (felt in the low back and hips) and is also a symptom not a disease. Aklosing spondylitis, however is a disease all by itself (but can also overlap with PsA in some people).
So it sounds like you have spondylitis and/or sacroilliitis and the rhuemy is trying to figure out which one (aklosing or PsA). I think they can usually determine which based on xray findings. (i believe aklosing fuses the vertebrea? Someone please correct me if i’m wrong). With sausage like fingers it is more likely to lean towarrd the PsA dx since i believe that’s pretty specific to PsA. Even if there is no swelling or pain at the time, slight changes to the shape of the joints can usually be seen in xrays. (in my case the xray tech recommended a bone scan due to these changes, which lead to the dx).
Hope that helps rather than just makes it more confusing!
Thanks so much everyone. All of you are so informative, it’s like looking in a mirror reading the stories, and helps me understand new symtoms that pop up!!