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

Op I was put on methotrexate after psoriasis nail psoriasis and then psoriatic arthritis diagnosed.

i couldn’t face the methotrexate and in a desperate attempt went into Keto. Two years on absolutely no symptoms. Of anything.

@FaiIureToLunch thanks for the advice, will take it on board. Can I ask how you responded to Mtx?

Hi OP, glad to hear you got a diagnosis. DH has opted out of methotrexate because of the side effects, but it's really down to how you feel about your symptoms in discussion with your doctor. The most impactful thing he did was to inform his team and occupational health at his work (county council) - that has been amazing in terms of his colleagues' understanding. He gets time off for appointments and they know that he needs a lot of rest around flare ups. He doesn't stop working, but might work from home and he's not as 'on the go'. He's also found remaining active to be really helpful both physically and mentally. He's currently awaiting toe surgery - he didn't realise it was PsA until looking up 'typical' symptoms. It's taken him a long time to understand the condition and recognise the symptoms, so be kind to yourself and consider it whenever you're feeling under the weather or have a niggling pain.

Wishing you all the best! x

Glad you got your diagnosis, it's a weirdly pleasing and disappointing experience, but there's treatments that can help and tell your rheumatologist about side effects or if it's not working well, there's other drugs if methotrexate doesn't agree with you, I do cosentyx injections once a month and the difference is amazing

Glad for you you got your diagnosis, now at least you can get treatment. I would suggest I am sure there will be support groups on Facebook specifically for PsA , I found really helpful not only understanding my disease but also how to help with self care & navigating the NHS.

Thanks for update. I hope the Meds agree well with you.

Yes there are, and I joined them. However, people on those seem to have such severe symptoms or must be much further down the line, it all seems such doom and gloom. Whereas anyone who posts about it on here seems to be leading a normal life with it 🤷🏻‍♀️

Arthur's place is pretty good, there's a Facebook group too. The posts will usually be people who are struggling at that time. It's not a linear disease, you'll have flare ups and good days, once you're on good medication you should have more good days than bad. You may have some damage and that could be a permanent issue, but if you've caught it fairly early and find a drug that works, you should be able to get back to being able to most things

Just ask, most people will feel like you at the beginning to their journey so will just keep quiet. Don’t be scared to ask sure even people with severe symptoms will remember the beginning of the of theirs be happy to share their experience. I am 3 different support groups as I have overlap of different AI. Best of luck.x