If you are a GP, and someone presented with these symptoms....

[overthehillswegoo]

What would you be querying?

Lower back pain for two years, mainly to the right side but can be central (pelvis x-ray came back normal). Hurst when standing still or seated, but fine when moving/exercising.
Pain/stiffness in middle of back when straightening up after bending over.
Nail psoriasis (diagnosed).
Occasional stiff neck, coinciding with headache.
Tingling/numbness in left foot (last 6 month) and sometimes up lower leg. Currently seeing a physio to help, and nerve conductor studies came back fine.
Bunions, and shooting pain in big joint.
Severe dry eye for two years (now being treated by steroid drops from opthalmologist).
Constant sore, flaky ears (previously given drops for 'eczema' in ears)
Red, sore rash on underams.
Red, sore rash around eyes (only really happens in Winter).
Genital itching/soreness.
Recurring sore elbow joint, hurts to rest it on desk whilst working.
Infrequent knee pain.

All of the above are happening now, not at different time periods.

Had brain and spine MRI to rule out MS (referred for this due to eye problems and, at the time, numb hands), both scans came back showing no lesions.

Lots of bloods tests ran for rheumatoid factor, deficiencies etc. All came back ok.

If this was your patient, what would you be thinking next? TIA

I'm thinking this too. Also Sjogrens, Lupus and long Covid.

@overthehillswegoo that's good
It's such a pain to be diagnosed and often feel like you're just crazy when doctors say nothing seems to be wrong with you
Do you know if they've tested your ESR and CRP levels and what they were?

I would be wondering if it's Psoriatic arthritis (I have alot of the same issues )

Sounds like your sacroilliac joint that's causing the back pain

Psoriatic arthritis would be my guess- doesn't explain everything but it does the main symptoms, esp joint pain with rheumatoid factor. You're the right age as well. Am surprised that this wouldn't have been considered already though.

(Not a GP- I have PA)

That should say without not with.

Thanks @Duckling771 I have no idea if they tested those. I will try to find out. It's been going on over 6 months now, the blood tests were that long ago that I've kind of forgotten what they did.
I definitely feel crazy some days, especially when others come on this post with "hypochondriac" and "health anxiety".
As someone who is physically fit, exercises strenuously every day, and tries to keep in a good physical state to put me in a good position for old age, I am definitely not somebody who goes to the doctor with every little niggle. I can see why that 'exhaustive list' in my OP may give that impression, but after a long time of suffering different symptoms, I'm now trying to list them all in the hope someone will put them together like a jigsaw!

@glast My physio is trying to help with SA joint, suggesting SAJ dysfucntion.
@MelaniaT It was considered back in Jan/Feb, but after presenting with other symptoms in March, the GP then queried MS before we got anywhere with the PA, and I'm now under neuro which now means PA query is 'lost'.
I guess I need to go back to GP

Did anything trigger all this? Could be worth putting together a timeline to show the Gp/consultant.

@overthehillswegoo yer I had an awful lot of hassle from doctors acting like I was wasting their time and making me feel like I was exaggerating, now I'm on amazing drugs that suppress parts of my immune system and don't need to go to the doctor's except for the odd blood test to make sure the drugs aren't effecting my liver/kidneys. Don't let them make you feel like you're imagining things, you have something, it's a doctors job to work out what the issue is

PA is tricky to diagnose. I'd definitely ask for a rheumatology referral.

Have the doctors ruled out 'invasive candidiasis'? Basically a widespread fungal infection - would explain quite a few of your issues (including joint issues, headaches, skin issues). Might be worth raising it with them if it's not been an avenue explored.

Google 'widespread fungal infection in body' and see if it rings any bells.

Psoriatic arthritis maybe?
Not a GP but a sufferer

Nail psoriasis is often a strong indicator of psoriatic arthritis (work in pharma and have done a lot of work in psoriasis, but not medical professional)

Definitely need a rheumatology referral - best of luck. There’s loads they can do now to help.

You’re definitely not diabetic?

Thank you everyone for taking time to read, and responding.
Those saying I need a rheumatology referral, do I literally just tell the GP I want to be referred to rheum?? I feel like I'm telling him his job!
(However, as I've been going private to see specialists, I guess I should just ask him anyway as I won't be wasting NHS resources)

@RhosynBach @Summerishereagain I have family history of diabetes, but looking at typical symptoms, I'd say no. I'm pretty sure I've been tested previously.
What makes you both suggest diabetes?

Type 2 diabetes.

Have your blood tests included the Hba1c?

Definitely PsA (not a doctor but a sufferer). Often doesn't show on bloods but accounts for almost all your symptoms. I though symptoms of psoriasis and joint pain was a trigger for referral to rheumatology

@overthehillswegoo yes ask your GP. May be worth getting the symptoms list from NHS website and telling the GP how many of the symptoms list you seem to be experiencing and pressing for a rheumatology referral on that basis.
My experience with many GPs is that they don't seem to be too aware of these sorts of things. I even had one explain my symptoms as period pain despite being on contraception that stopped my periods. So go prepared if you can, the GP that recognised it may be arthritis with me was a god send

Re occurring thrush.

Other than genital itching and dry eyes, I don't seem to fit the bill for type 2 diabetes @YukoandHiro
I have bundles of energy and definitely no weight loss (as much as I'd love to shift a few lbs...)
Also not excessively thirsty.
I'm sure they tested for that

My gp’s are amazing and have diagnosed lots of stuff. I never get chest infections….

Are you on any medication

Ask for referral for infectious diseases, you sound like me.
after I had the covid vaccine in 2021 I had a massive reaction and every gland swelled up everywhere. Even now after where I had the vaccine is still swollen and sore even now two years later.
i was told only yesterday that if someone has a reactive immunity what can happen is a virus or a vaccination can then cause their bodies immunity to become extremely reactive and can start attacking Joints and organs causing inflammation throughout the body.

You mentioned about your back did the MRI use the contrasting dye? Because it sounds like you have trapped nerve that is causing your symptoms. I was diagnosed with CES and my large disc’s had gone central and crushed my spine cord. This stopped everything working from hips down. I remember the sensations I felt the tingling, burning and numbness. Autoimmune problems can cause a number of symptoms like Lupus or RA.
you mentioned dry eyes my eyes are terrible when they are very dry I can feel my eyelids stuck on my eye and have to bath them. I also get a mist in my eye sight and it goes very blurred. My mouth is extremely dry and the dentist give me fake salvia YUCK sweet ! but it stops tooth decay. I also get ulcers on my tongue and white lumps growing on my gums.
you obviously have a immunity problem I’d definitely ask to see a consultant in infectious diseases and Rheumatologist.
Also you can have RA and your R factor be normal it could mean your just starting to suffer with the disease it’s self. But in time you probably will test positive at some point.
Remember there is no clear testing for any autoimmunity disorder. They use these tests because they are a guide. But if you have clear symptoms and the consultants have seen them then I’m sure they’d say yes if definitely autoimmune diseases.
not sure if you had the covid vaccine but I’ve been doing some research into it and some people get complications due existing problems some suffer from strokes others it’s their heart and others it’s blood clots, then others it sends their immunity into overdrive and they start with autoimmune symptoms.
The doctors know this and it’s freely talked about. I watched a talk about the harm the vaccine had caused some unlucky people and many doctors are now standing up and saying this vaccine caused these people to get extremely Ill. I’m no anti vaccine I had my covid and flu vaccine within weeks of each other and it nearly killed me. My immunity went into overdrive. Now my hands are so swollen they look more like crab crawl's. My knuckles have been so swollen for 13 weeks . The pain is a deep ache (like I’ve broken a bone ) then every so often I get a sharp stabbing pain. It’s also in my wrists, elbows and shoulders. I wake at 2 am and my fingers are like ice. I feel like if I move I will break into a thousand piece’s. Plus I feel like I have a constant low fever and I feel totally exhausted like I have the flu. I’m already taking tramadol, morphine and others for nerve pain.
if I was you I’d sit down and write a timeline. Even the smallest detail could help solve this. I started with constant dry eyes and throat then I got sore throats and swollen glands in my chest and collarbone. It was a very strange sore throat because the pain from my throat would shot down my neck into my collar bone and just ache . I felt so run down. It would take weeks to go and go for a week then come back. My glands popped up under my arm and in my chest. After a few months of all this going on one morning I got up and my knuckles were huge and even the palm of my hands were filled with fluid opposite side to my knuckles, within days my fingers were swollen like jumbo sausages. The Middle joints and knuckles are so tight and painful the pain actually makes me feel sick. I also noticed I was struggling to take a deep breath in and felt so chesty. Then my shoulder joint started on both sides followed by the elbow and wrist then numbness in fingers then tennis elbow . If I tried to hold just a small cup. Picking the kettle up and filling it with water is impossible. Then I started getting these hard swellings on my joints that were sore. They look like white small pockets of fluid.
I really hope they find out what it is normally if they see the symptoms they will still diagnose you and keep a close eye on you. Since autoimmune problems are based on testing and taking your medical history as well they may try you on a medication to see if it helps.

did they do your inflammatory markers?
if symptoms seem to get better but them come back you must get all your bloods done again.

you could be at stage 4 RA before your markers get raised. Some people take months / years to get a diagnosis.
They say if it’s RA you should be on treatment with 7 weeks to stop joints getting badly damaged.
I know I’m not a GP but I’m going through a similar thing and I thought I’d share
You take care of yourself