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Diagnosing P-Arthritis
from Cynthia D.

I am currently undergoing testing to figure out what kind of arthritis I have so I can start some sort of treatment.  Here's a little history:

My Mom has lupus and my younger sister is a flaker.  I'm 38 years old and over the years have had various aches and pains but the past year has been much worse and more pronounced.  I finally saw a rheumatologist in September and she thinks that I have P-arthritis.  She did blood and x-rays and reports that my antibody levels are "normal" and the x-rays pretty much showed what she expected for someone with joint pain.

My next test is a bone scan and more blood and back again to the doctor.  I don't have any skin symptoms at this point.

What can you tell me about P-arthritis?  Is there anything specific I should be on the lookout for?  Is there anything I can do at this point to help myself?  I am on Bextra everyday and also take glucosamine supplements as well.

Thank you so much.  -Cynthia D.

*****

Ed’s Response:  Probably the best concise description of psoriatic arthritis I can recommend is the one contained at WebMD.com.  Here is the direct link

http://my.webmd.com/content/article/74/89263.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}

Be sure and copy the entire URL, beginning with "http..." and ending with "...A348}" into your browser's address line.  If this fails, just go to http://www.webmd.com and search on "psoriatic arthritis."  This should be the first reference the search results deliver.

It sounds to me, Cynthia, like your rheumy is right on top of it — meaning she's doing everything possible to identify your condition.  Though manifesting PA before skin P is not so common, it does happen, and given the history of immune system-related diseases in your family (lupus, psoriasis), and the fact that normal arthritis indicators from blood tests are NOT present in your case, PA is likely.

When you and your rheumy become convinced that your problem is PA, and when the symptoms become severe enough to warrant it, she will probably recommend methotrexate.  My rheumy initiated my first course with this drug — which lasted a year and resulted in a complete remission of my PA and a substantial improvement of my skin P.  Methotrexate (a.k.a. MTX) is not without its drawbacks.  You shouldn't use alcohol while you are taking and drug.  The drug also requires constant blood tests (typically monthly) to ensure no liver damage is occurring.  Fortunately, if you and your doctor are diligent about monitoring your liver function while you are on MTX, signs of liver dysfunction can be caught early, and the drug dose reduced or stopped with no permanent damage done.  I've had two courses of MTX now and would go back on the drug without hesitation if my PA threatens to become disabling. 

Good luck to you!  -Ed

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