Non Erosive.
Hi, I have psoriatic arthritis and fibromyalgia. Recently my rheumatologist of 6 years retired and my new consultant referred me to someone else to access my joints. In the letter he said that Fibromyalgia was more of an issue and my psoriatic arthritis wasn't active.
But what is bothering me is that he said because my blood markers were low, previous scans showed no erosio or inflammation n, my arthritis is non erosive. The thing is blood tests have never been accurate with my arthritis and I with 3 months to get those scans, by which time the symptoms we were trying to capture had settled down. Also, I have heel spurs on both feet, which my previous consultant said were due to the enthesitis he diagnosed in both heels. However, this new consultants does associate PSA with Heels spurs because anyone can have these.
Am I wrong to raise these to him? I'm concerned that this will offend him and affect our relationship going forward. This is really bothering me and I don't know what to do.
You are never wrong to raise ANY issues to your doctors. Only you can advocate for yourself. While it is true that labs are poor indicators of Psoriatic Disease activity, CT scans and X-Rays can pretty conclusively show the degree of joint erosion going on. And while heel spurs are certainly a condition of PsA, they can occur independently. However, your having already been diagnosed would point to PsA as the culprit. So, go ahead and raise these concerns with the new guy, and don't worry about offending him. And if you still have concerns with him, get a referral to a different doctor, and be sure to state your reason for doing so. Hi, thank you for the reply. I don't dispute the erosion not found in the scans, in fact, I welcome it. What it is bothering me is the point about no inflammation. The this is I had to wait 2-3 months for the scans, which by then the PSA flare had settled, I mentioned this to my rheumatologist at the time, but he was adamant about going ahead.
Also, I spoke to people on my a PSA social group who have had PSA for 30+ years, and are only now getting bone erosion. So labelling mine as non erosive seems daft to me.
Finally, this new doctor is very well regarded in the field of PSA, so if he decided to remove me from his books, I wouldn't know what to do. Also, I think most doctors wouldn't change their opinion once seeing his name. He was trained by Doctor David Walker who was my first rheumatologist, and he was highly respected.
Thanks again for the replying to my plight.
is right. Never be concerned about bringing something up to your doctor. I read your reply to Eric_the_Eric. If your doctor is genuine then he will listen to your concerns and address them. We have to be our own advocates when it comes to our health. Maybe tell him that your other labs have always been off. It would draw his attention to those. If he is that respected in the field of PsA then I truly believe it will be fine because it is only when we address concerns that we get the best care possible. Vickie, Team Member Hi Vickie, thank you for replying to my post. I think you're both correct in saying that a frank but respectful conversation is needed with the new guy. I found the definition of "non erosive" arthritis, the page says it is someone with mild symptoms. I strongly disagree with this as my condition can be anything but mild.
I also need to say that although I don't have any imaging of inflamed joints, I do however have two senior consultants stating over the last eighteen years, that I have inflamed joints. The image below shows how nasty my arthritis can get, this flared involved multiple joints, but my feet were hit hardest.There's also a condition that many of us suffer from called synovitis, inflammation of the synovium, or the lining of the joints. It's part and parcel of PsA. Spongy, stiff, painful joints. This is something that isn't detectable on x-rays, but requires advanced imaging methods to see. However, a good rheumatologist, in the absence of erosive damage, active or otherwise, should be able to infer, without the additional imaging, that this is the cause of your pain. And, since your feet have so many joints (I believe 30 in all) they can be hit particularly hard in PsA. have you shown your rheumatologist the image you shared with us? If not, I would take it with you and show him/her that picture. If I remember correctly, you said your other rheumatologist retired. Do you know if the new Rheumatologist still has access to the other doctor's medical file on you? If you are not sure I would ask the new rheumatologist especially if that older doctor had seen you for years. It would help the new Rheum to understand everything you have been going through. Vickie, Team Member
