PsA Diagnosis
I was diagnosed with PsA in Oct 2022. It was my first rheumatologist and appt and I had no idea what to expect. She was super nice. I gave her blood work from my PCP which showed mild elevation of CRP, and vitamin D deficiency, but nothing else conclusive. I told her my history and what brought me to a rheumatologist to explore this as an option to explain why my body was freaking out on me. I explained I had scalp psoriasis since I was a teenager but didn't know that's what it was until 2017. It was treated by dermatologist and I haven't seen it since. I explained I have swelling in my hands in the morning, but usually decreased by lunch time. I explained I have tremendous back pain that is worse in the morning. I had an MRI that showed arthritis (it's apparently osteoarthritis, which I didn't know at the time) and was so surprised by that. I told her my mom was diagnosed with osteoarthritis at 15, which seemed odd. But sounded like they went with that because she didn't test positive for rh factor. I explained I'd get random all over body fatigue, but chalked that up to being a new mom. I explained that when my back was experiencing extreme pain and tightness prednisone made me feel 80% better the next day. And from that she concluded I had PsA. I stopped seeing her because it became extremely difficult to communicate with her office and I started experiencing Drug induced Lupus from the Humira I was taking so I sought out a new rheumatologist. And now after a bunch of testing, she doesn't think I have PsA. And I'm just baffled. I'm starting to doubt the last year and a half. I greatly improved on the Humira (hand swelling went down so I could wear my wedding rings, way more energy, back pain got better but never fully went away which makes sense) even though it gave me DIL. Am I being gaslit. Does this happen? It's not like I want an autoimmune disease. But am I just supposed to erase the last year and half? As of now I'm only taking an rx NSAID for my back pain. I still have the swelling and uncomfortable-ness in my hands, I've also developed achilles tendon enthesitis, and I have all over body fatigue. She's tried to explain away all of it because the MRI she took doesn't show evidence of SI joint involvement. I don't even know how to advocate for myself at this point. I'm just at a loss.
sounds like you have been through a lot. My first question to that rheumatologist would be to find out what she knows about psoriatic arthritis. They so readily dismiss psoriatic arthritis because there is not a set test that will say it is so. I will tell you what one dermatologist told me one time and that is if you have psoriasis and your experiencing pain it is psoriatic arthritis hands down. I have always went on that principal. For her to dismiss your family history of psoriasis is just unreal. I have never heard of not having SI joints involved making it not be arthritis. My suggestion would be to go onto the National Psoriasis Foundation website at www.psoriasis.org and see if they have a rheumatologist listed for your area. Please let us know what comes about all this. I would have a hard time dismissing a year and a half as well. Vickie W., Team Member 
I would tend to agree with Vickie on this. However, even though the overwhelming likelihood is that your symptoms are PsA, you can have psoriasis concomitant with RA, too. But it's far more likely that it's PsA, and it is unlikely that your treatment would be different, regardless. I am of the thought that you have PsA, but you deserve answers, and maybe the new doctor has some. I think the first thing to do is ask your new doctor why they believe, despite previous diagnoses and family history, that your condition is not PsA. Additionally, ask for a detailed diagnosis, and why that diagnosis is more likely than a diagnosis of PsA. If you feel you aren't getting satisfactory answers, then it would be the time to seek out a new doctor, or see about getting back in with your previous one. 
Hello
, When I hear stories like this, I get mad. I got psoriasis in 1963. I started to have symptoms of PsA at the age of 25. I didn't get diagnosed until I was 50 but had to search for a new dermatologist. It was so hard to convince my healthcare team that I was in pain. I agree with what everyone is saying, look for someone else. We are in the 21st Century and still dealing with this. We have to be our own best advocate. Thanks for sharing. Diane (Team Member)
