Psoriatic Arthritis?

[CupOfEarlGrey]

I've just seen my rheumatologist (who I like very much) and her feeling is that I have Psoriatic Arthritis and not PMR. The reasoning is that - even though I have no psoriasis on my skin - I had bad swelling and pain in my knees and hips when I first went to see her about 2 months ago. However, the pain in my knees has almost disappeared now, due to the pred (prescribed for the supposed PMR) in her opinion.

I've tapered down from 15mg to 8mg of Pred and she's keen to continue the slow taper off pred and start me on Sulfasalazine. The side effects seem a bit alarming - does anyone have any similar experience of a re-diagnosis of psoriatic arthritis and/ or taking Sulfasalazine?

Thanks so much!

[PMRpro Ambassador]

I wish I understood their logic - I had a rheumy who wanted my PMR to be PsA and put me on sulphasalazine which didn't happen as I was about to move here to Italy and hadn't got a consultant here to monitor me. Fifteen years later and under a world expert in PMR there is not the slightest suggestion what I have is anything other than PMR.

[CupOfEarlGrey in reply to PMRpro]

That’s really interesting. Hmmm. I’m loathe to add anything else in to the mix as, at the moment, everything feels pretty much under control… did you have pain in knees or other ‘non typical PMR ‘ places?

[PMRpro Ambassador in reply to CupOfEarlGrey]

Personally, I'd want some more proof before starting sulphasalazine. Not that sun exposure is much of a problem in the UK ...

What makes them think it is PsA?

[CupOfEarlGrey in reply to PMRpro]

They think it's PMR mainly because of the pain in my knees (which has now gone - although there's some swelling there still, apparently. Who knows the logic??

[PMRpro Ambassador in reply to CupOfEarlGrey]

PMR or PsA?

[CupOfEarlGrey in reply to PMRpro]

Sorry!! PsA!!

[PMRpro Ambassador in reply to CupOfEarlGrey]

PMR does knees too

pubmed.ncbi.nlm.nih.gov/238...

[CupOfEarlGrey in reply to PMRpro]

You're brilliant! Thank you so much PMRpro Really useful. xxx

[Sharitone]

Fwiw, my knees swelled up with my biggest PMR flare, even though that wasn't part of the initial presentation.

[Pollyanna16]

I had PMR & Psoriasis & my consultant was keen to put me on Methotrexate. I kept this at arms length for a few years. The PMR disappeared but due to constant injuries etc I was referred for an MRI of my spine this year to see if there was any inflammation there. There wasn’t & so end of long saga… no Psoriatic Arthritis after all.

[L8kside]

I was recently diagnosed with psoriatic arthritis. He tried me on methotrexate first - had bizarre reaction to that which included hair loss and confusion -stopped that one!

Started on Sulfasalazine - hair loss became worse! And had flare of finger joints all hurting and thoracic spine pain. He finally took me off Sulfasalazine Now we had to figure out what to try next!

Responses to meds are so individual it’s hard to try and share what you might experience. Wishing you all the best!

Susie

[PMRpro Ambassador in reply to L8kside]

Hair loss is a common adverse effect of methotrexate, especially if they haven't given you a high enough dose of folate/folic acid with the MTX,

[CupOfEarlGrey]

Poor you! That sounds really grim. Hope they figure out something that works for you soon

I have my NHS rheumatologist appointment tomorrow. Watch this space! x

[Bcol]

I don't understand the logic here. You were diagnosed with PMR and prescribed Pred which would seem to have been successful and taken away some if not all of the pain. Why stop something that is working and try something new?