Normal imaging and blood

[smilelines]

Sometimes I wish that an ultra sound or MRI or some sort of imaging would show that my joints and tendons are inflamed. Or that my blood would be off. Everything is always normal except for signs of osteoarthritis on X-rays. I have had this soreness for four years now. Firstly diagnosed with fibromyalgia and a year later by a different rheumatologist as RA and fibromyalgia to now PsA like arthritis and fibromyalgia. The rheumatologist feels the joints and says that many are boggy although they don't hurt or look swollen to me. I feel it more in the muscles and tendons. She says that is my fibromyalgia. It is just confusing because I can't tell which is which yet I am expected to say how my inflammatory arthritis is and whether I need more medicine. No idea if I am sore due to fibromyalgia or inflammatory arthritis. I can tell the sore osteoarthritis joints though. So, I am going on cosentyx and I sure would like to know how to better self evaluate so I know if it is working. Maybe it will be amazing and there will be no doubt. Or maybe it will be like the leflunimide and I will have no idea if it is working. Are others in the same position?

[wilbertjellyfish]

I think you have summed up the problem.Ultimately, it doesn't really matter which condition it is, as most of the treatments cross over so you try things to see what makes you feel better.

Your body is complex and you can't isolate one thing from another and when you are in pain everything feels worse but there are lots of treatment options and your DRs are trying things which is great.

Fingers crossed this helps.

[cyberbarn]

I am sorry to hear about your struggle with diagnosis and finding something that works for you. One of the problems with Fibromyalgia is that is sort of doesn't actually exist. It is just a social construct, that is people have made it up, of a collection of a wide range of symptoms. The problem is that sometimes once someone has been diagnosed with fibro they struggle to get anyone to take them seriously because many see it as a 'mental health problem' and not a physical problem.

I am surprised that your rheumatologist is saying that the feeling in the tendons is fibro while diagnosing you with PsA because one of the signs of PsA is tendon problems.

Here is a paper that gives a history of fibro and some of the problems with the diagnosis.

ncbi.nlm.nih.gov/pmc/articl...

But, as they say, the proof is in the pudding. I had to fight to get to a rheumatologist (in the UK you can't get a referral from a GP if they suspect you only have osteoarthritis) but when I finally found one and they started me on a COX2 NSAID I felt soooooo much better. I had forgotten what it was like to have a hand that could make a closed fist! But sadly that also did for my GI tract so I was moved on to other drugs.

So if you take this new drug, and you get an improvement, then you know that it is likely to be an inflammatory arthritis. If you don't, it might be that that drug isn't right for you, and hopefully they will try another.

In the mean time, read the criteria for fibro, decide for yourself if you really have it, and if so which symptoms, and try to address those yourself.

Good luck! It can be a full time job when you have a condition like this!

[smilelines in reply to cyberbarn]

Thanks for your response. Yes, it seems like fibromyalgia is quite difficult to diagnose and my physiotherapist thinks that it is what they say you have when they don't know what is wrong. I liked the explanation that it is always preceded by a significant lengthy illness and it is the brain overstimulated to pain. But who knows if that is correct. My rheumatologist says my puffiness is the fibromyalgia and that sure doesn't fit the idea that it is in the brain.

[oldtimer2]

I was actually quite surprised when a new specialist nurse agreed with me about my 'boggy' joints. The previous one had just looked at me as if I was loopy. If you feel with the other hand using the grip of the fingers and thumb, place over the joint between the finger and the palm of the hand you're examining and press down slightly - it gives. When my joints aren't boggy, it is firm.

[smilelines in reply to oldtimer2]

Thank you. I watched a few videos and tried to self assess my joints but didn't feel anything grape like squishy. Will keep trying!