New to Forum: PsA diagnosis still not 100%

I'm excited to find this forum. Here's my intro: My extended family has auto-immune issues. My mother died from complications of lupus, 1 of my sisters has uveitis and PsA in her ankle, and my mother's sister had psoriasis as do 2 of her children.

For me, after being told for 10 years that the deformity in my hands was due to osteoarthritis, I was diagnosed with PsA 2 years ago. Because I have no psoriasis or history of it myself, the question has remained about whether I have PsA or Inflammatory Erosive Osteoarthritis. I have swan neck deformity in several of my fingers, but I also have hyperflexibility in my fingers (and hips) which could possibly account for the swan neck. The distal joints in my fingers are quite deformed at this point (curved and swollen and calcified). My toes are starting to curve. I have one obvious sausage finger.

I've been on MTX for 2 years and did a challenge a few months ago to see if I had the erosive osteo (not responsive to MTX) or PsA (responsive to MTX). My rheumatologist had me go off the MTX to see if it was indeed helping. If it helped, then it confirmed PsA. If I noticed no difference, then no PsA. Within 2 weeks I had a lot of discomfort in my hands so we agreed I had PsA. I've been having a painful flare the past month so am ready to move to a biologic. First, though, I'm in the screening phase of a clinical trial for biologic-naive patients. The question is whether they'll actually accept me into the study given that I have no psoriasis. Anyone else have trouble getting a definitive diagnosis because you don't have psoriasis? I look forward to hearing your stories.