Do you always have to have swollen joints with psoriatic arthritis?

[tinkywinkyshandbag]

Hi, I have a longstanding issue with pain in my feet and ankles and I'm wondering if I've been misdiagnosed. If you have psoriatic arthritis,do you have the classic signs of sausage fingers/toes or swollen joints?

A few years ago (I'm 53) I went to see my GP about pain in my feet and ankles. I was sent for an x ray, they also did a test for RA, which was negative. I was told that it was osteoarthritis (mild) and basically there was nothing I could do except stay active.

Since then it's got worse and worse, I have very tender feet and sore ankles, they feel stiff and sore, much worse in the mornings, but sometimes at night they burn and ache. If I sit still for any length of time I have to limp/hobble for a while when I get up. Basically my feet and ankles are on my mind all day and I live in flat, comfortable lace up shoes.

I've also developed achilles tendinopathy on one side and more recently ankle tendonitis on the other side, I self referred to a podiatrist who told me it's tendonitis, and who gave me exercises but they don't seem to really help. My ankle especially on the side with the achilles issue definitely seems swollen, I feel like it's lost all definition around the ankle bone.

I've now started getting stabbing pains and aches in my fingers especially at night and tenderness in my hands and sometimes in my knee.

I don't feel this is right for an active 53 year old. It's making me depressed and feel old before my time.

My GP previously said because I don't have sausage fingers or pitted nails it's not psoriatic arthritis. But having done some more reading I am not so sure - is it worth a second opinion? Does it make any difference in terms of treatment?

I do have psoriasis by the way on my arms, knees, and tiny patches on my face and body. Thanks, I'd really appreciate any input from anyone who has PsA. Thanks.

Hi. I have diagnosis of seronegative inflammatory arthritis probably psoriatic arthritis. No rash and xrays and bloods fine. Nor do I have any obvious swelling. Fortunately I saw a rheumatologist who has good knowledge of psa in an early arthritis clinic and she was able to feel swelling in lots of finger joints. I would push for a referral to rheumatologist who has interest in psa or go private to one.

Just to add a lot of your symptoms are like mine. It's very important to get early aggressive treatment for inflammatory arthritis so don't be fobbed off. Psa is very difficult to diagnosis and most don't know much about it.

I have psoriatic arthritis in my knee occasional pain no swelling my brother has it and does have swelling so I don’t think it’s black and white

sent you a pm, op.

Hi thanks all, I think I will see if I can get a GP appointment to discuss it further. I know they don;t like people playing "doctor google" but the more I research it the more I think this is what I have.

Given you have psoriasis, and a story of it being worse in the mornings, and it now affecting your fingers, I'd go back and want a referral to rheumatology.

My friend has this. She has no swelling in her fingers or ankles that I’m aware of, it’s her knees that suffer and have to be regularly drained. It’s been controlled with methotexate and other meds since she was diagnosed at 16 though, so hard to tell if it would’ve affected her ankles or hands.

My mother has psoriatic arthritis, op. The description of your symptoms sound like hers.

Hi all thanks, I've joined a support group on facebook and have done a lot of reading, I've got the NICE guidelines and they say everyone with psoriasis should be assessed for psoriatic arthritis every 10 years. I've got a GP appointment (phone call) booked for Monday, will see what he has to say.