Diagnosis

Posted Sun 7 Apr 2019 9.41am by Headshoulderskneesandtoes

Hi all

After having pain in feet,ankles,wrist,fingers etc... went to mt dr January 2019. After blood test was told I had gout, another 2 weeks and I went back and said I don’t think I have gout I tick more boxes for ra or psa.

Sent for x -rays they came back mostly ok apart from bone spur on metatarsal and dip joint disfigured. Radiologist put this down to birth defect? I didn’t except this and asked to see a dermatologist becuase my psoriasis was really bad and rheumatologist becuase of all the pain everywhere.

Dr said ok but loads of people have clicky joints etc... 2nd April went to dermatologist and he said after examining me that the creams and lotions he could give me even light therapy wouldn’t help in his opinion. He said it was his humble opinion I had psa and needed tablets such as methotrexate and these can only be prescribed by a rheumatologist once condition confirmed by them.

I told him I had an upcoming appointment and he said he would also put it in his letter to my dr I needed to see a rheumatologist and had possible psa. He said he couldn’t diagnose psa himself as that’s not what a dermatologist can do clinicaly. He gave me some foam spray for my worse psoriasis and said this will help in the tome between getting a diagnosis.

He also said I had Dactylitis on toes and fingers I also have severe nail Psoriasis with pitting and lifting on both toes and fingers.

My question after my long winded post is have others had gp dismiss them or wrongly diagnosis gout etc and only when they insist on seeing a specialist they get a proper diagnosis

Posted Wed 10 Apr 2019 9.23pm by joe
50%-ish psoriasis coverage, scalp, elbows, shoulders, back, stomach, calves, toes

Not exactly the same as you but this was my experience:

In the past about 10 years ago I was referred by my GP to a local NHS Rheumatology clinic (UK) for tests and diagnosis for widespread movement limiting joint and body pain symptoms: feet, ankles, knees, lower back, neck, elbows, wrists and knuckles. I suspected that these pain symptoms were related to my psoriasis but I hadn't had an "official" medical diagnosis. My psoriasis had surfaced in my late teens and the general body pain started to surface about 10 years after that.

After having blood tests and undergoing ultrasound scans and xrays, I was eventually diagnosed with a condition that was added to my medical record as "arthritic symptoms". I was sent packing with diclofenac on a repeat prescription which presumably was the approved treatment for long term use at that time with an expectation that this would be good enough pain management and also prevent further deterioration. I was recalled for follow up Rheumatology clinic consultations a couple of times after the first visit.

"Arthritic symptoms" never did feel like a solid diagnosis to me, I was left with the impression that none of the tests that I'd undergone or the ultrasound and xray observations had led the doctors to any concrete conclusion about what this general pain condition was exactly.

Diclofenac didn't really work for me at all, I stuck with it for about a month then gave it up completely. Since I wasn't opposed to pill popping at all at that time, I switched to cheap over the counter Ibuprofen which seemed to work more effectively and from then on I kept on popping Ibuprofen pills for years.

I honestly don't know if I was unlucky with the treatment / diagnosis that I received. Perhaps it wasn't that at all and rather I have some very tricky to diagnose condition. I do know that I eventually lost confidence in all of the Rheumatology and Dermatology experts.

In recent times I've changed my diet, I've stopped taking painkillers and pared my topical skin treatment back to occasional Dovobet ointment patch treatment (i.e. once a fortnight) and general moisturisation with Epaderm. I'm virtually pain free nowadays and I can attribute this improvement directly to my dietary changes. I'm certainly not as flexible as other people in my family but I would say that compared to how I used to feel day in day out, my "arthritic symptoms" are now as good as non-existent.

1 Posted Thu 18 Apr 2019 10.57pm by wendyloish

I think what you are writing about is a common problem, and I wonder how many people there are out there who are suffering in the belief that they have osteoarthritis when in fact it is psoriatic arthritis. Certainly I was in this boat until a few years ago. I think the problem stems from the use of X-rays for diagnosis. Radiologists only see the damage done to the skeletal system, without seeing the cause. The damage from osteoarthritis and psoriatic arthritis apparently is the same. Assumptions are made.

Even when a doctor is looking for autoimmune problems, all the bits of the jigsaw may not be put together. Seeing a new doctor and describing your long medical history, how many people with only mild psoriasis would bother to mention it? I have had psoriasis for 55 years. It is not on the top of my disease list. And it was not on the file of my latest medical clinic (been there only 8 years) until a year ago.

It was about 25 years ago I was tested for lupus, and the blood tests came back with elevated autoimmune markers, but not high enough to be certainly diagnosable as lupus. So the problem was let slide with a course of antibiotics. In retrospect not the right answer!

Like Joe I am using diet for successful symptom control. That does not reverse the damage, but my "arthritic symptoms" are gone. And that includes the nerve compression in my lower back that was causing me to fall over.

So how many people are there out there continuing to suffer from "arthritic symptoms" who could be helped? I suspect a lot! In today's world of sedentary living with modern technology, how many of us have done enough physical work in their lives to have completely worn away the cartilage in their joints? But while GPs make assumptions and radiologists are given the task of diagnosis, the current status quo will prevail.

I do have a hope that people with psoriasis will become aware of psoriatic arthritis, and so will be able to put the jigsaw together themselves. I try to be an optimist. But realistically, it is unlikely. I have friends who have "arthritic symptoms", who have the telltale fingernail problems, and yet still don't listen, because they have no plaques. We have a lifetime of trusting the medical profession to overcome, and the internet is flooded with pseudo-science. Most people will get trapped by one or the other. it is hard to be an optimist!

wendyloish

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