2nd opinion for PsA?
I had a RA evaluation & it was negative; however, all my fingernails have lines from nailbeds to tips, that are thin, split easily at edges, & I get deep cracks/some bleeding in cold weather. 3 toenails are thickened & lifted. Use OTC anti-fungal. My RA Dr “insists” that I must also have pitting in my fingernails to be PsA. I don’t. I had bilat knee replacements due to arthritis. Foot arthritis Podiatrist said could fuse the bones (I refused), & heel spurs. My dad had scalp psoriasis & probable ankylosing spondylitis. (He was in his 80’s, bent over like an “L” but orthopedic didn’t treat as he was in hospice). I am Dx with O.A. but should I consider 2nd opinion? I live for the hot tub & water class! (Prior to knee surgeries, used cane & store riding carts due to knee& foot pain.) How to find out if it’s PsA? Vs O.A.? when Dr says I don’t have pitting of nails?
Hi
getting a second opinion would definitely be wise. You could also contact the Patient Navigation Center of the National Psoriasis Foundation and get some information from them to take with you. You can find the PNC on their website at www.psoriasis.org or you can call them at 1-800-723-9166, option 1. Hope this helps. Vickie W., Team Member - Thank you for the info & your opinion on second Dr.! 
Absolutely get a second opinion! Nail pitting is not a must for PsA. And any rheumatologist worth their salt should be able to differentiate between osteoarthritis and PsA on films.
. Thanks for input. I read it can be hard to diagnose. (He was concerned about my foot MRI, the tendons to bone something & the heel spurs. I had a 6-cm split tear on peroneal brevis tendon at the time) But not concerned my nails with those lines, go figure.
