Psoriatic Arthritis Q & A

I was diagnosed with RA at 26, and took NSAIDS for a number of years. Currently, 62. RA seemed to disappear in early 50’s. Now I’ve developed psoriasis mostly on elbows and now on lower knuckle of hands and some leg lesions.Three months ago I developed knee joint problems and then tore hamstring and calf muscle without much exertion. Was given PT for the muscle tears and Supartz for the knee. Since then the pain in the legs have become severe with anti-inflammatories giving some relief. Have only seen an orthopedist and he thinks leg and knee pain just from osteoarthritis. Could it be Psoriatic Arthritis?? and whom should I see. Dermatologist took care of the psoriasis.

I have psoriatic arthritis and peripheral neuropathy. The peripheral neuropathy is bilateral L>R. My neurologist does not know what is causing the neuropathy. I need a knee replacement on the left. Is there a contraindication to knee replacement in psoriatic arthritis and peripheral neuropathy. Also, is peripheral neuropathy common in people with psoriatic arthritis. I am a FNP and my lit searches only reveal peripheral neuropathy w/ rheumatoid arthritis. Do you know of a clinic specializing in psoriatic arthritis in NC or surrounding area? Thank you, Dianne

What are the alternatives to plaquenil for psoriatic arthritis? I have been on 2 x 200 mg for almost ten years, and the eye doctor has concerns that is has started to damage my eyes. I also take an injection of methotrexate once weekly (.9 ml I think).

Developed Trigger Thumb (locked extended) treated with cortisone shot, told to see rheumatologist since they feel I have PA not RA like I was told 35 yrs ago. Have in past used, Indocid, then Entrophen, then ASA as I felt need if I had a flare. this last flare lasted 3-4 months and was worse than any I’ve had for many years(just went away a week ago and now i feel good), but unsure if this trigger thumb requires further treatment, ie surgery, since I’m told this cortisone shot will wear off before long (had it May 4th). What more help can a rheumotologist do for me? What should I ask surgeon about thumb…since one surgeon said too many risks to do surgery on me, and second surgeon said, definitely need surgery, I’m 53, excellent health 9except for RA or PA, no meds, appropriate weight. Want proper use of thumb with no possible recurrences. Gladys

Enbrel and Humira causing extreme fatigue. A couple of years ago I started on Enbrel weekly after my first psoriatic athritis flare-up. I found that, while it did dramatically reduce pain and inflammation I experienced overwhelming fatigue and weakness.(Without it/prior to Enbrel I would suffer a 7-8/10 on the pain scale, even after taking the max daily dose of Tylenol and Celebrex.) If there were an equivalent of the pain scale for fatigue, I would place myself at (9-10)/10 for the first 48 hours. (E.g. Found it difficult to sit up, breathing was somewhat labored; I was essentially incapacitated.) The weakness would start roughly 8 hrs after the injection and very gradually subside over the course of 5 days. During this time the pain gradually returned (to peak at 8/10 on the 7th day just prior to my next shot), with the net effect that I was essentially dehabilitated for the entire week. Early this year, at my urging, my doctor switched me to Humira (1 injection every 2 wks). Initially, I was relieved that I had less fatigue, but after 5 mo. I have found that Humira follows essentially the same pattern, except that it has a much milder impact (i.e. milder fatigue just after the shot, but also much less pain and inflammation reduction). TNF-alpha blockers are ideally supposed to increase energy; why would they dramatically reduce it? Thank you.

I have been taking Enbrel for several years (50mg every week) but recently has stopped being effective to address my psoriatic arthritis.  My doctor recommended increasing the dose to 100mg a week or switching to Humira.  He believes that my overweight condition is not allowing the Enbrel to be successful.  Any recomendations between Enbrel and Humira?