Psoriatic Arthritis Q & A

RA, PsA and AS at the same time?

I was diagnosed 3+ years ago with Psoriatic Arthritis, Ankylosing Spondylitis, Osteoarthritis, and Fibromyalgia. I exhibit a number of stereotypical signs of PA, such as severe pain and inflammation in my hand and foot joints; particularly in the end joints of my fingers and toes. I frequently experience Achilles tendonitis in both feet/heels, as well as tendonitis in both my wrists. I also have tightness in my chest accompanied with tenderness in the joints around my breastbone. In addition, I have severe pain and inflammation in my lower back that causes pain and limited range of motion in my right hip, as well as a feeling of having pinched nerves and numbness in my groin area. Similar pain, stiffness, and inflammation in my neck that affects my right shoulder and arm also occurs. However, I lack one key symptom of PA; psoriasis. To date, I have not had any skin changes or symptoms.

Though my blood work continues to be negative for RA, I still question whether some of my symptoms do, in fact, point to RA rather than PA, such as the absence of skin symptoms and the occurrence of nodules on various joints.

I currently take Methotrexate and Enbral to treat my PA and AS. While this has helped to a slight degree, nothing I have tried to date has helped to manage the symptoms completely. Even one day without pain would be a blessing.

First, is it possible to have RA even when blood work indicates no? Second, are the medications used to treat PA the same as those used to treat RA? Third, is it possible to have both PA and RA? Lastly, are there any new treatment options to reverse the damage and stop the pain?

Tight Feeling in Chest a Symptom of Psoriatic Arthritis?

I am experiencing a tight feeling in my chest that is very uncomfortable. I had a chest x-ray today and it is clear. I have asthma, but the neb treatments have not given me any relief. I have psoriasis and have recently had my index finger swell to the point where I coundn’t bend it. My brother is on remicade for psoriatic arthritis.. do you think this chest discomfort could be a symptom of psoriatic arthritis?

PA and TNF inhibitors

I have had PA for c.5 years and pretty much exhausted all the treatment options (due to lack of efficacy or side effect profile) – other than TNF inhibitors which my rhumatologist would like to put me on. Prior to doing so I would like to get a second opinion and discuss which TNF inhibitor might be best suited. As such I was wondering if you might suggest any of the rhumatologists the Arthritis Centre in having a particular specialization in PA and might have availability within the next month or so for an appointment. Thanks.