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PSA - yes or no

I recently moved to a new state and upon seeing a new rheumatologist, he questioned if I really have PSA. I have been on Cosentyx but not getting relief from it and feel much better not on it frankly - that’s a whole other story with co-pay assistance and new insurance denying the medication. He did a huge battery of blood tests and X-rays of all my major joints since I have not had X-rays since being diagnosed 6 years ago. All blood normal, X-rays show osteoarthritis everywhere. I’m wondering if anyone has experienced a misdiagnosis.

  1. I once had a new rheumatologist take me off my meds after running a similar barrage of tests. Things went from bad to worse, as I self-medicated with OTC anti-inflammatories to ease the pain. I knew better, but I added a glass of wine every night to help me sleep. After several months of this bad behavior, a better rheumatologist started me back meds. It took about 6 months to get my liver enzymes back to normal and a year to get the pain under control. I understand why a new doctor needs to run tests, but a good one understands that some of us (maybe a lot!) are sero-negative. A good rheumatologist also will know that you should be treated BEFORE bone erosion occurs, before permanent damage is made to your joints. Yes, there are instances of misdiagnosis, so I encourage you to get another opinion. I believe that you simply must advocate for yourself with your doctors. No one knows your body or your pain better than you.
    Maybe a new provider will be willing to listen to your symptoms and try another medication. I also have osteo arthritis in certain areas, and the tendon pain with PsA does confuse things. An experienced rheumatologist should be able to help you!
    I feel for you and all of the confusion you have going on right now. You'll no doubt hear more stories similar to ours. I don't think it is all that rare to have your diagnosis questioned by a new doctor, but please seek another opinion before believing it!

    1. If you have psoriais, chances are that you probably have PSA. Most people with PSA have at least one inflammatory marker elevated, mine is CRP. ESR is another test they look at, but it's not uncommon for it not to be elevated or just slightly elevated. All these test can also be impacted by heart, kidney, liver, and so on. The point I am getting at is that they are not all the accurate and largely depend on the person. Also, treatment that is working will often makes the inflammatory markers lower.

      I think it would be advisable to seek a second opinion.

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