Hi, I know you are not doctors or rheumys but I would really appreciate your take on this photo. I was diagnosed with PsA earlier this year but I was visiting my mum this weekend and noticed her fingernail. She is 78 years old, has developed a very painful hip which the ortho said is bursitis, has pain in one knee, and I am sure you can see the deformed finger joint. She has no skin involvement. I was just wondering if I should suggest she see her GP to explore the possibility of PsA or at the age of 78 would treatment even be introduced? I am thinking it may be kinder to say nothing rather than put her through the mill of DMARDS, she only complains of pain now and again and seems to cope well enough with pain meds. I would really appreciate your feedback on this, I’m not sure if I should even mention my thoughts to her, she has early stage dementia and I don’t want to give her any worries unless it’s really necessary. Thanks so much for reading.
My mom was just diagnosed a few years ago in her late sixties. Her diagnosis was made after many many years of being told that it was osteoarthritis in her hands and no explanation on her nails. She has been doing very well with treatment, and was surprised to find out how much of her pain was actually due to PsA.
Because of the added issue of dementia, I would probably start off with her GP, and discuss this issue.
Thank you Stoney. I think that’s good advice! It never occured to me she may have PsA until I noticed that nail.
Hi minky! Ugh your mom’s fingernail looks like PsA to me. The crooked finger is probably OA–a couple of mine are crooked like that. Her fingers don’t look swollen, so hopefully they’re not very painful.
I hear you, Minky. I think your suspicions on that nail are probably right on, and your instinct for not pursuing the possible diagnosis is pretty sensible. But I’d discuss it with her GP for sure. I think I’d want to know what she has. After that you can always decide whether or not to do something about it. Here’s the thing: if she has a diagnosis and you decide to “let it ride”, if she suddenly goes down with a flare, the rheumatologist will know what to do to keep her comfortable. On the other hand, if there’s no diagnosis already in place, that’s when they are going to start scratching their heads and thinking about what it might be. And that is not the position you want her to be in.
Another perspective. Before I was diagnosed, I had several years of caring for my poor Mom. Besides aches, pains and fatigue, she had a giant brain tumour and advancing dementia. (You can imagine …) She also had itchy “stuff” in her ears and white scabby things in her hair. I asked her GP what that was. He said eczema and dandruff. I figured that we had bigger fish to fry than eczema, so we didn’t bother with it. Mother died. Then (the same day as a matter of fact) I was diagnosed with an unknown type of inflammatory arthritis. Not a good day. Then they started asking me questions like “did any of your close relatives have arthritis or skin disease?” See where I’m going with this? Fortunately, the eccentric and foul-mouthed derm I saw heard my description of Mom’s skin and, without hesitation yelled “OF COURSE SHE HAD PSORIASIS, WHAT THE **** IS WRONG WITH GPs?” That was not a good day either. 
I’d say find out as much as you can, for everybody’s sake. Just my humble opinion.
Thank you for such a well though out reply!! and you know what Seenie, you are absolutely right. I am really sorry you had to go through that horrific ordeal with your mum. Ill be making an appointment to see her GP, Im hoping she is willing to speak to me alone. I just think at this point to involve my mum is a last resort, as she is so very anxious about everything. If the GP can think of some guise to get her to a rheumy, it would be sensible to have the diagnosis in place. My mum cant manage her own meds which are all for minor ailments so I know that the DMARD route would need to be really necessary before adding more worry onto her. Thanks to everyone who took the time to reply, you really are a great bunch here.
Minky, I think you’ve got a good game plan there. I’d be surprised if the GP wasn’t willing to speak to you alone if your Mom has early stage dementia.
Yes, it was a horrific ordeal that my Mom went through (there was a lot more “stuff” – a ruptured eyeball, a retina repair, a craniotomy at 87) but if a few people can learn from her/our experience, then at least something positive can come out of this. My Mom lived to help others, and she did so to the best of her (limited) ability, pretty much until she died. If she only knew that her difficult experiences have helped some people in the UK, even in a small way, she’d be so very pleased.
Glad you joined us, Minky! Let us know how things unfold, won’t you?