is this psoriatic arthritis?

[reef]

I used to play football 3 times a week and for the last 6 or 8 months I have felt a pain in both my ankles which never shifted. About 3 month ago, I twisted my left ankle so badly while playing that I needed a stick for walking for 2 weeks and after some excruciating pain suddenly my left ankle felt much better. By then I knew there was a swelling and fluid around the ankle. An MRI scan showed that one tendon was completely torn and in the words of my GP, 'a mess!'. Now a swelling started to appear on my right ankle - no cause or trigger! One GP said it could be PsA and a more experienced one said there is no sign that i have arthritis. After seeing 2 rheum consultants who both thought it PsA, am waiting for ultra sound scans to confirm. The other problem that is happening in parallel is a supposedly 'frozen' shoulder for which i had an arthroscopy decompression about 2.5 months ago. The pain runs through the full length of my arm at any time and there are days when it's constant. Little evidence of psoriasis - some dandruffy scalp and ears and a red area on my jaw. The consultant promised me that it will go into remission and there will be no joint damage. I'm trying to hang by these words but according to some of the stories that I read it might be just positive encouraging words in the face of a dreadful disease. I hope he's right. On the other hand, a friend of mine has rheum arthritis for the last 2 or 3 years and she's gone through a knee replacement and a lot of pain. Yesterday, I watched while she was helping in building a new fence! There is life with arthritis.

[Dotty7]

There is definitely hope, and the sooner they catch it and treat it the more likely it is that the treatment will be effective. It sounds like you are lucky in that doctors aren't sending you away to wait and see. I was lucky like that too - my GP spotted it on my first visit, did blood tests four days later, and a rheumatology referral as soon as the results came back. I have also been lucky in that the pain and stiffness responded quickly to treatment, and I was back riding horses within a few weeks. Apart from getting very tired very easily, I am in many ways fitter than I was before.

Good luck,

Dotty xx

[reef in reply to Dotty7]

thanks Dotty and really good to hear that you're, God willing, out of danger. I'm waiting for the ultra sound scans before they prescribe treatment. What medicines did you use or are still using?

[Dotty7 in reply to reef]

I'm taking 20mg of methotrexate each week, along with folic acid which is prescribed to counter some of the potential side-effects. I also take hydroxychloroquine twice a day, and prescribed Vitamin D twice daily too. I take cocodamol as and when I need it for pain. I'm not sure I ever feel out of danger because RA meds have a history of working well for a long period and then suddenly not working any more, BUT I do feel very lucky to be as well as I am right now and determined to crack on and do lots with my life while I can. Just in case one day I can't. I never want to be the person stuck in an armchair thinking "I wish I had..." - I'm making darn sure I'm sitting there thinking "I'm glad I did...."

Dotty xx

[reef in reply to Dotty7]

That sounds like a low dose so hopefully negligible side effects.

[Dotty7 in reply to reef]

I don't actually have PsA, I have RA. Methotrexate is taken in small doses ranging from 5mg up to 25mg, once a week, usually starting at a low dose and increasing over a number of weeks as you find out how well your body tolerates it and how effective it is at controlling your disease.

I'm happy to answer questions to the best of my ability, though would prefer to stick to personal messages through this site. That said, the advantage of posting an open question on the site is that you will get the benefits of lots of people's experiences.

Dotty

[reef in reply to Dotty7]

No probs. Sorry I mistook RA for psoriatic arthritis.

[Dotty7 in reply to reef]

Cousins but not quite twins!

[Hidden]

Hello

Over thirty years I have suffered from Psoriatic Arthritis, with the skin condition, the tests involved are basicaly the same as RA, it is a condition that arrives from an over reactive immune system. You can find out more regarding this condition on the charity PAPAA web page, from there you can work out what your condition is.

Most of your condition seems to have been caused by sport injuries, Ps is thought initially to be a genetic condition and flares can be caused by mental stress, although this still may be hypothetical.and flares can be caused by weather, season etc.

Generally the effected joints are small joint. such as fingers,toes, spine, neck, also shoulders your hips can also suffer. One area that PS can effect is the tendons. Damage to joints can be very noticeable or no external damage may be seen, negative bloods may not show RA.

The treatment is generally the same as RA with the exception of light treatment that helps with the skin complaint. Both skin and joint have flares

Sometimes OA can be hidden and further tests may need to be undertaken.

I hope that this will help I have suffered from PSA for over thirty years. You really need to wait for a diagnosis from your specialist. Sometimes this condition MAY burn out in your 50s-60s This may never happen.

Go on the PAPAA web page and that will explain to you the types of PA and the treatments that can be carried out

If you need support, you will be afforded here

Good Luck

BOB

[reef in reply to Hidden]

thanks Bob. that's a very long time with PsA. I hope it's under control now.

[Hidden in reply to reef]

Hello reef

Seems in remission, although I have a good idea when the flares happen.

You are asking regards medication

NSID medication to reduce swelling

Tens machines to control Pain

Pain killers sometimes normal analgesic medications or Opiate medications.

Amytryptalene Anti Depressant medications for Nerve Pain.

DMARDS Medications that suppress the immune system

BIOLOGICS That also suppress the immune system

Hope that is helpful

BOB

[reef in reply to Hidden]

yes thanks. I hope it's in remission and for good.

[Hidden]

PsA can be difficult to diagnose. But although I have no medical background I think it's sufficiently common knowledge for me to say that you can get it without having had the skin condition, sometimes that comes later & sometimes you may have or have had Psoriasis but in a very minor way. What is most associated with PsA is nail changes (I've heard about 80% of folk with PsA show nail changes) so make sure your doc checks your nails carefully. It is not always a dreadful disease & of course treatment has improved massively recently, same as for RA. If you continue to have problems then don't panic but do keep pressing for answers. Early treatment is the way to go with any kind of inflammatory arthritis.

[reef in reply to Hidden]

Thanks postle. i think that might be my case - little sign of psoriasis but the main symptoms are the slight swelling on my ankles and the near constant pain on my arm which is thought to be due to a frozen shoulder but i suspect all are linked.

[Barrister]

I was diagnosed with PsA in the summer and don't have psoriasis except for flaky itchy inside of ears and some funny looking nails. I have lots of pain in ankles, feet , hands, back and neck and have done for years, but no actual joint damage so am hoping that it stays that way. Clemmie

[reef in reply to Barrister]

How do you manage the pain? and also are you able to do any activities like running?

[Barrister in reply to reef]

At the moment I take Ibuprufen and paracetamol together and occasionally Naproxen because I'm really dreading taking MTX because of the side effects. I have good days and bad days - on the bad days I have to accept that I won't be doing much. I was first diagnosed with RA whilst I was in Saudi Arabia last April and began taking Hydroxychloroquine but stopped taking that when it caused unbearable itching. When I got back to the UK I got a second opinion and was diagnosed with PsA and Hydroxychloroquine isn't prescribed for that as it can make psoriasis worse apparently ( although I don't currently have psoriasis). Anyway, I know that I will have to give in and try DMARDS again because of the pain and stiffness. But I have been suffering with this pain for over twenty years so I know that I can manage. And as for running, I didn't do that before the pain and stiffness! But I walk a lot and try to walk a couple of miles every day because it helps a lot. And I found a really nice physio who recommended yoga which helps with the stiffness (although I don't do it as much as I should) and I'm going to start Pilates too. I hope that you can get some help and can get back to doing a bit of running. Clemmie

[reef in reply to Barrister]

Many thanks for sharing your case. I assume PsA treatment involves immunity suppressants which is my main worry because I have another skin disorder called pemphigus foliaceous which is under control at the moment thanks to immunity suppressants. Adding more of these Imm. Supp. to the system worries me.

[Barrister in reply to reef]

You need to discuss your worries with both your rheumatologist and your dermatologist. Perhaps there is a particular DMARD which is suitable for both problems? I don't know but your consultants will be able to help you with these issues. You have to look on the positive side even though it can be difficult at times but many people have positive experiences from the drugs used to treat the disorders. Take each day at a time. Clemmie

[Slightly_ginger in reply to Barrister]

I have similar pattern of skin conditions as you, although I have seen in belly button and my GP said my scalp is quite bad. My skin was brilliant on 20mg of Prednisolone but now on 5mg the skin has started to play up.

[Slightly_ginger]

I've been diagnosed with PsA a few years ago, and have "some dandruffy scalp and ears and a red area on my jaw" this describes some of my skin problems exactly!

Obv. This does not mean that you definitely gave it, and of course you need to continue with your medical diagnosis.

Good luck with everything.

[reef in reply to Slightly_ginger]

thanks. how do you feel now and how are you joints in general? are you on any DMARDs?

my main worry is the possible loss of ability to go to work.

[Slightly_ginger in reply to reef]

Hi. I have many joints affected, my specialist nurse counted 84 in my last visit. These include most joints in fingers, wrists, elbow, knees, ankles, lower back, shoulders.

I currently take a weekly injection of enbrel which is a new type of biologic therapy. I tried the 3 most popular DMARDS over a three year period but with no success.

I stopped working in 2011 when I was sacked by my company after a capability study found that I would not carry out my duties. My situation is complicated by having cancer of the kidney and lymph nodes. So my experience isn't the best.

Being able to work is very subjective obviously, I didn't do any manual work, but travelled a lot and drove to meetings in Europe etc etc.

I feel unable to work at the moment due to the combination of my illnesses, which is frustrating along with it being financially disastrous. BUT IT MUST BE stressed that everyone is different and everybody's experience and abilities are different too, so don't be too disheartened. Early diagnosis and early start of treatment is the best thing.

Also trusting your body and energy levels to tell you enough is enough.

I take a slow release morphine every day along with paracetamol and sometimes ibuprofen. The morphine not only helps with my Psoriatic but obviously the pain associated with the renal cancer. Cheers I do wish you all the best.

[reef in reply to Slightly_ginger]

that is tough but it's good that you manage to keep a positive outlook. i wish you all the best.