Could this be psoriatic arthritis?

Posted Sat 14 Dec 2019 12.27 by Neen

I am 39 and have had pain in my big toe joints for the past year and a half. At the time I started feeling pain, I had x-rays done and blood work taken to check for inflammatory arthritis. Nothing showed up on any of the tests. Multiple doctors had different opinions on what was causing the pain, but eventually settled on the decision that it must be the early stages of osteoarthritis that just wasn't showing up on x-rays yet. (Though by the time I got this diagnosis, they could feel/see some bone spurs over the joint.) So, this seems like a reasonable diagnosis, but given that there's no real evidence it's still just a guess. And the thing that's bugging me a bit is that my toenails on those particular toes have been a bit "gross" for 3 or 4 years now. Not bad enough that I saw a doctor about it, but when I started googling joint problems, I came across psa and I think the nails do look like they have psoriasis. They have extra white at the ends where the nail has detached, I have a salmon spot on the nail and they are bumpy. None of the classic pitting on those nails. My fingernails are pretty okay, but I have a single pit on one nail and a splinter hemorrhage on another. I DON'T have skin psoriasis. However, my sister does. It's important to me that I get a correct diagnosis so I can get proper treatment. But I am loathe to go to the doctor looking like I was googling for diseases. If my arthritis is inflammatory, then I think psoriatic arthritis is a decent possibility. However, I don't have morning stiffness and my visible swelling is quite minimal. I recently had significant swelling after a run, but I don't know if that's considered inflammatory. For those of you with psa, did any of you not have the classic symptoms of morning stiffness and swelling in the early stages? Thanks.

Posted Sun 15 Dec 2019 23.01 by TA LKI N GHE AD (edited Sun 15 Dec 2019 23.04 by TA LKI N GHE AD)

Mine started with unexplained swelling and pain in my right ankle which went away and then came back a few months later. The second orthopaedic surgeon I saw took one look and said "you have arthritic feet". I had assumed my thick, discoloured toenails were caused by years of football and squash. Tests ruled out rheumatoid arthritis and given I had a history of psoriasis, a few patches, psoriatic arthritis was the diagnosis. I was prescribed methotrexate but I found one study which found no evidence of its effectiveness with psoriatic arthritis. Given that and the fact that it's quite toxic I was quite keen to reduce my dose and hopefully get off it. This is not an ringing endorsement but I found some of the contents of "Healing Psoriasis The Natural Alternative" by John O A Pagano quite helpful. I still have grotty toenails and some psoriasis patches but I've been off methotrexate since June 2017 and free from ankle flare-ups since before then. It may not help everyone but I think some of the lifestyle changes discussed in that book helped me.

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