Has anyone got psoriatic arthritus that can help ?

[goingmadnow]

My fingers and wrists have been hurting now since the end of my pregnancy (now 5 months post partum) no warmth but definitely swollen hands as my ring now leaves a constant indent when it didn't fit me properly before !
I've always had flare up's of really dry itchy skin on my hands that eventually cracks and bleeds and gets very painful. The doctor said it's hand eczema.
No psoriasis, but my sister bless her is covered from head to toe in it and it's very bad.
I've also got two dodgy big toenails, I thought it was a fungal infection but from reading it seems it can be a common thing in people with this type of arthritus??

I've had bloods done and all normal apparently. No inflammation etc. so wtf is it ?? My nan had rheumatoid arthritus but I'm not convinced it's that really as no warmth in my fingers. Just this bloody pain. It hurts most in the mornings, when pushing the pushchair, lifting heavy things etc

Can anyone help? I feel like the gp isn't taking me seriously because the bloods are normal

I had a very swollen finger and then a swollen toe which was awful when walking. I went to the docs and was referred to rheumatologist. I've had scans, blood tests, ultra sounds which all came back normal. It was only because at an appointment for ultra sounds and then the follow up that I had a visibly swollen finger that it was escalated. I was on daily anti inflammatorys for a while and now I'm on immunosuppressants. I have no psoriasis but originally was given a diagnosis of psoriatic arthritis but then it changed to inflammatory arthritis. I take my meds and I'm completely ok now. No side effects from drugs and no new swelling. I would try to get referred as it's a long waiting list. Good luck

There are no tests for psoriatic arthritis, a rheumatologist will diagnose on symptoms plus the fact that other things have been ruled out.

It does sound highly likely you could have it.

Please push for a referral, the earlier you have treatment the more likely it is to go into remission.

Thank you both. I am going to push for a referral because it isn't going away. Some days are worse than others though, I could have a really painful hand one day then the next it's like new?!
Just feel like I'm always calling the doctors atm but I just know something isn't right, I'm early 30's and shouldn't have frequent joint pain like this.
I'm also having nightsweats too - could this be linked ?

My GP took one look at my swollen ‘sausage toes’ and said I think you have psoriatic arthritis (I do have a long standing history of psoriasis) and the rheumatologist confirmed it. I did have bloods etc done as well. I have psoriatic nails and toenails too - the toe nails can definitely look similar to a fungal infection. Unfortunately there is no treatment for the nails, but I found a great podiatrist who is great with my feet and also does gel toenails for psoriatic nails! Definitely go back to your gp and ask to be referred. I have a friend who had no problems at all and out of nowhere developed a painful foot. She went through months in a moon boot, every test under the sun until psoriatic arthritis was eventually diagnosed. She had only a very small patch of psoriasis on her scalp. Are you sure the hand break out is eczema? I have recently started to get a small patch of psoriasis on the palm of my hand

Just to add i started to get sore joints and pain in my early 30s and two of my friends were the same. It seems relatively common to start noticing symptoms at this age.

Sounds classic PsA especially the bit where it varies from day to day. You need a referral to a rheumatologist.

I am diagnosed with psoriatic arthritis.
The only skin issue I have is my scalp and sometime behind my ears.
My finger joints are inflamed and stiff.
I was getting shooting pains in my little fingers.
Apparently the inflation marker blood tests are not always reliable as they can fluctuate. I was diagnosed by rheumatologist after a GP referral. I take meds which I was reluctant to do but was advised to take them to prevent the problem escalating.

I'm not sure it's eczema to be honest ! It's on the back of my hands especially over the knuckles and extends down onto the middle finger joints and sometimes goes around my wrist. It doesn't look like psoriasis though as I'm so used to seeing my sisters and hers are these big red clumps of skin, it's not like that just extremely dry and my hands are a little red over the knuckles.

I was convinced it was a oregnancy related thing as it started about 36 weeks with swollen and stiff hands in the morning, but it's got worse not better

I can also get little shooting pains, sometimes it goes up to my elbow

I have a friend with psoriasis on her hands and how you have described it is how hers presents. There are different presentations of psoriasis. Another friend was specifically recently warned by her health visitor than many women have a flare up of their symptoms after giving birth, usually between 12 and 14 weeks as the pregnancy and post birth hormones leave your system, which would seem to chime with your experience as well

@goingmadnow
Yes, mine went up the arm. Strange painful sensation

hi
i was 32 6 months after having my youngest. I already suffer with paoriasis (thankfully atm the flare has gone into remission) but i blamed the covid pfizer jabs for giving me the biggest flare to me known. And the fact that i was getting bone pain almost everywhere everyday after..i had social services before it happened which may have brought on by extreme stress. I was ringing the gp alot about why am i getting this everyday and that i cant function with the kids. Up a hill to school. Nope no one took me seriously until dr gave out a big sigh and asked me hows your psoriasis going. I said not good. Blood test normal. Told to come back few weeks no. In a few days rung again.was getting lyphm nodes on neck. Then i said i want scans on my neck. Different doctor said rhometologist ..... basically
after xrays on hands and feet chest more bloods i was also diagnosed with osteoporosis and phoriatic artiritis and couldnt get an mri bc no childcare.
You need a rhomotogist!!!

Thanks everyone, it's so helpful to hear off people with real life experiences. At this point I think the gp thinks I'm just anxious but I know something isn't right with my hands and wrists. Today my ankles are really hurting which is new.

I will say now that they've done all they can bloods wise and I would like to be referred on to a specialist

You can have either psoriasis arthritis or seronegative Rheumatoid Arthritis with normal bloods.

When my seronegative RA started it was exactly how you describe yours. I was luckily send to a rheumatology consultant quite quickly as I couldn't walk with the pain and lifting and changing DS was impossible.

The consultant did an ultrasound on my hands and feet and found "mouse bite" holes in my bones and swelling in the synovial fluid. I had a few steroid injections which helped but I didn't take any immunosuppressants as I wanted to keep breastfeeding. Which turned out to be a mistake, as although the injections really helped my hands and wrists the fatigue and general unwellness meant I ended up in hospital and poor DS got his last book feed in a&e and then I was away from him for 10 days while DH tried to work out how to make him drink from a bottle.

If you can afford it I would see a rheumatologist privately and make sure it's one with an ultrasound - I don't know what the waiting lists are like where you are, but in NI it's 7 years!!!!!
The consultant will then usually put you on their NHS list, horrible that it's come to having to bribe your way in.

My consultant told me that seronegative RA is more common in women after childbirth as the connective tissue used to grow the baby goes haywire and doesn't know how to react after- so attacks your body instead.

Also, if you have any family members with any type of autoimmune disease - which you do with your sister having psoriasis, you are more likely to have one too, even if it's a different breed. Eg my mum has chrones.

Apologies for the essay.

I have Psoriasis on my hands & feet, too; my fingertips and toes crack & bleeding frequently. But I already have Osteoarthritis so my GP didn't seem bothered about taking investigations any further.

When you mentioned about toe nails it reminded me that both of my big toe nails look like they are almost separating or lifting partially from the nailbed, but are still attached. Sorry, its hard to explain,. It looks awful and, at first, I thought it was a fungal infection but that was ruled out. Also all my nails have become very ridged & lumpy, and a few are a bit pitted.

I give up with the doctors - I straight up asked to be referred to a specialist and was told no. The doctor is convinced my joint pain in my hands is caused by hand eczema. Is this a thing ?? Does eczema cause joint pain ??

When I google 'eczema and joint pain' first thing that comes up is it's link to RA... now is that just a coincendence I have eczema on my hands and this is where my joint pain is ??

Psoriasis runs in families and is linked to arthritis, commonly starting in the hands. Nail psoriasis is a good indicator of joint involvement, up to 90% of those with nail psoriasis will have psoriatic arthritis. I think it's more likely you have psoriasis rather than eczema but they can look similar. The PEST assessment tool might be useful. PsA can be very destructive and requires early referral to rheumatology.

Back to the GP and insist on a 2nd opinion.

Ask why they are ignoring the link between possible psoriasis and hand joint pain and either RA or PA.

Honestly I'm so pissed off she was really dismissive - twice now ! I will ask for a second opinion yes. I don't understand how she is so convinced it's eczema when I have the joint pain along with it... everything I've read there is no link with eczema and joint pain - the pain with eczema is from the skin being inflamed not the joints.

Oh I also mentioned how with psoriatic arthritis it doesn't show up on blood tests in alot of people, she said it does my Inflammation markers would show something

I just looked at the NICE guidelines.

Ask them to use the PEST - Psoriasis Epidemiology Screening Tool.

Preferably see a different GP.

Familiarise yourself with the NICE guidelines for Psoriasis and Eczema and Google images of the different type of lesions.

Spoke to a different doctor this morning - I have finally been referred to rheumatology 👍🏻 she really listened to me, said eczema does not cause joint pain.
She said with my family history of psoriasis and RA also my symptoms I should have already been referred regardless of my bloods appearing normal. I know there will be a long wait but I'm just glad to be on the list. Thanks everyone for all your great help!!

Oh also got some steroid cream for my hands !

So glad you've been listened to by the GP.

Now you have to keep going and know your stuff for the Rhuem too.

Tip: familiarise yourself with the signs of fibromyalgia- then you can argue the point with the Rhuem that you don't have it and can push for further testing - which is essentially an ultrasound of your hands and feet which they will have in clinic.

Make sure they know you are aware that psoriasis arthritis is seronegative and also that seronegative Rheumatoid Arthritis exist and the time for a first flare in women is usually after childbirth.

It's shit that we have to push to be heard, but such is being a woman in the medical system.

Good luck and I'm so pleased you've got past the first hurdle, hopefully things will get a bit easier soon.

I found a ring sling really helpful for feeding and helping hold DS round the house as my wrists just weren't up to it. I changed him on the bed as it was too hard to get down on the floor. I never lifted him in the car seat as it was too heavy, but luckily he was a decent snoozer so I could get him into the pram/cot without waking him.
Also I had a high raised carry cot in the living room so he could sleep during the day and I didn't have to bend down too far.

How did you get on OP?