Anyone here have PsA and RA?

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Liz M

Posted Tuesday, February 24, 2009 4:14 PM

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I have had psoriasis for about 8 years and started having chronic worsening back and neck pain a few years ago. I also have intestinal issues, eye issues, bladder issues, etc., etc. I had a friend who was dx with ankylosing spondylitis and thought her symptoms and those of PsA seemed to fit me, so last year I went to the Rheumy. No damage seen on x-rays at the time and I was also seropositive (not sure about anti-CCP's or ANA), which I know usually rules out PsA, but he said I could have both PsA and RA. Anyway, I got a huge flare about 4 months ago - complete with fatigue, joint, muscle and bone pain. I present symmetrically, which I know is more typical of RA. I now show damage on u/s in my wrist (and God knows where else - I have felt pain in EVERY joint this flare). Have an MRI to schedule on my spine/neck. I am currently having another flare, but I haven't started meds yet (MTX soon).

So, does anyone on here have both PsA or AK and RA? Or anyone know about this? Thoughts?

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Wayne Hauber

Posted Friday, March 06, 2009 10:00 PM

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I posted a similar question a few months ago on the psoriatic arthritis forum at www.psoriasis.org. There were some folks who responded that claimed to have both diseases. I've done a lot of reading about the topic since that post.

Tests that distinguish between RA and PsA are not of much help. It is really impossible to get a decent diagnosis of PsA. I was told that you can test positive for RA and still have PsA, that you can test positive for PsA but really have RA. You can test negative for both but still have the diseases.

A research group in the UK has some MRI scans of the enthesis which they think provide a definitive diagnosis of PsA...complicated topic...and there is still debate about this test.

I've read journal articles that suggest that the five classifications of PsA might even be meaningless. I have come to the conclusion that rheumatologists do not know much about PsA...the science is still being developed.

My rheumy says that it doesn't matter if I have RA or PsA...he says that he will treat me the same. We talked about this at some length and he almost convinced me.

I went to Mayo for another reason but got a complete rheumatological workup in the process. I was negative on all of the tests for autoimmune diseases.

The diagnosis from both sets of rheumatogists was that I had OA in many joints with an unusual inflammatory involvement. Since I have had psoriasis for 40 years, they thought that there was a reasonable chance that I would present as a PsA case in the next few years.

In any case, I was told that my rheumy was on target with his advice. So, I'm taking plaquenil to see if it will help, MTX might be a second or third choice. I probably have PsA but no one can tell for sure...they don't seem too bothered because they are going to treat the disease the same way, at least at the beginning.

(For my part, I am taking lots of flaxseed oil, evening primrose oil for omega-3 oils and glucosamine/chroiten. The flaxseed/evening primrose oils helped me stop a large psoriasis flare up two years ago and are supposed to be helpful...who knows for sure? I have strengthened my legs and that helps too.)

So, I am coming to the conclusion that it doesn't matter what flavor of inflammatory arthritis I have...at least not now...my arthritis is very mild. If the condition changes then maybe the treatment will change.

Anyway, if you ask your original question on the PsA forum at www.psoriasis.org, you may get some positive responses. Sorry for the rambling reply but this is a topic that is bugging me a lot and I wish someone could give a definitive answer.

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starshine

Posted Saturday, June 06, 2009 2:08 AM

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Hi Liz, I have read this thread several times and have not posted because no doctor has told me I have both but I think I might. I have had RA for 24 years and about 4 years ago I developed a rare form of Psoriasis called Palmoplantar Pustular Psoriasis or PPP. When my PPP was at its worst, my fingers had the classic sausage shape of PsA instead of the spindle shape of RA. When I asked my Rheumy if I now had PsA instead of RA, he said no because I was seropositive. I also have rheumatoid nodules which are not found in PsA. My X-rays always show RA. So....I think I very well could have both RA and PsA. I haven't asked a doctor though and both my RA and PPP are in complete remission with MTX and Enbrel so I no longer have the sausage fingers. My Rheumy is monitoring my meds now and I don't intend to go back to my Derm because I don't like him. ss

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mary lee

Posted Thursday, June 11, 2009 5:53 PM

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i have psa, fibromyalgia, rheumatoid and osteoarthrits. the psa moves from joint to joint in my body. i have had 2 mri's on my right knee both showed degenerative changes. my hands and wrists show the same. enbrel, mtx, gold and now humira with no relief from any of them. i have tried changing my diet, exercising and vitamins to no avail. its very difficult to cope with this disease. i was diagnosed at 32 and am now 47. i could not live without aleve and now that is hurting my stomach.

no one understands my pain, i guess that is why i am here.

praying for a change and some relief! w00t

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bamagirl68

Posted Wednesday, August 26, 2009 2:32 PM

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I was originally diagnosed with PsA because I had a history of psoriasis. However, my rheumatologist told me recently that I am seropositive for RA. I also have Sjogren's and that is seen with RA, not PsA. However, I very well could have both. Lucky for me!

________________________________________________________________________________

Michelle

Diagnosed with psoriatic arthritis in 2006. Later changed to RA and Sjogren's syndrome.
Remicade, mtx, prednisone, folic acid, plaquenil, evoxac, tramadol, darvocet, aspirin, naproxen.

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SassySyl

Posted Saturday, September 12, 2009 4:46 PM

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Here is my run down:
JRA @ 6 months, PAs @ 29 and OA @ 33.

I have been told that PAs and RA are so much alike that its hard to say if one or both exist in one body--however, I was told at my last rheumy visit I am seronegative. So, what is a person to believe? Blink

I think even the Dr's are confused so they make it up as they go. This is not meant in a wrong way towards the doctors.

I have a spine that is so bad it broke right at the area where us girl's bra connects. And my hips are another story. Every thing I seem to read points only to PAs...I also have skin involvement plus organ involvement as well. My eyes are the worse. I have maculas that look like swiss cheese. As for JRA, I'm not bothered these days like I was when I was a kid with this. It appears its the PAs that is really causing the problem but my Dr. tells me otherwise.

I hope this was helpful...

Warm Thoughts,
SassySyl

JRA, OA, PA, and Fibromyalgia

Medication Mix:
Humira 80mg; MTX 30mg; Prednisone 2.5 to 5 mg; Xanax 1 mg; Tylenol extra strength (when needed on very bad days); Darvocet 100mg

A smile is worth a thousand words and a kind word is worth more than a thousand smiles

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