My son is 27yrs old he has a learning disability and mobility problems. Approximately 6 years ago he developed psoriasis which is quite severe from head to toe. After numerous treatments he's now on 20mg methatrixate. During the past 2 years he's been suffering from severe wrist/hand pain, then shoulder pain and now back pain. The GP did some bloods and said its possibly psoriatic arthritis due raised inflammatory markers. He was referred to rheumatologist. After asking my son questions (my son has a learning difficulty) but he didn't want my answers! He said he didn't feel he had psoriatic arthritis. My son is 27years old his ESR is 43 his CRP is 15 and his URIC acid level is 517. Should I challenge this decision? What are your thoughts? Meanwhile my son is still in pain on copious amounts of painkillers!! Please help...
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Shazo29
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I know a bit about psoriatic arthritis ( PsA ) as I have spondyloarthropathy and they have similar symtoms and belong to the the same group of diseases.
It is fairly rare and can be challenging to treat. Has gout been ruled out given his high Uric acid level as it can cause joint pain?
Certainly Methotrexate is used to treat PsA too but if it proves ineffective then many patients get a very good response to biologic drugs, specifically anti TNF's. I would see if there is a charity for psoriatic arthritis and get in contact with them to see if they can recommend a Rheumatologist near to you who has a special interest in PsA as it can be difficult to diagnose. Your son is entitled to a second opinion if you live in England. In my experience it's important not to give up and keep pushing for answers. Did the Rheumy you saw give your son an adequate explanation for his continued pain?
If you want to you can send me a PM with your location and I will see if I can find a knowledgable Rheumy near to you.
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38 year on woman temple arthritis 
Not the answer I was expecting
Arthritis and pmr
Methotrexate or not? 
Is Tramadol anti inflammatory??
