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Date: 02.01.2011
From: Sharon W

Subject: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

Hello there,
I have just being diagnosed with aggresive Psoriatic Arthritis and I am in heaps of pain etc... That is a differnt post on (I am new to this forum).

I was wondering if anyone can tell me what the difference in PA and RA as I read the symptoms and they seem to be the same.

Thank you very much for any help xx
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Date: 02.01.2011
From: Sharon W

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

Sorry about my spelling in the above post, do you know I think the PA is effecting my grammer also.

xx
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Date: 02.01.2011
From: Nicky

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

Hi Sharon
I just went on the internet and found this hope it helps.
What are the differences between psoriatic arthritis and rheumatoid arthritis?
There are over 100 types of arthritis. What are the differences in the clinical picture of psoriatic arthritis and rheumatoid arthritis, other than the obvious additional symptoms of the skin disease psoriasis?
Answer: Joint inflammation and stiffness in patients with Psoriasis, and RA share a common feature. Both conditions are caused by an erosive inflammatory arthritis. The distribution of joint involvement however, differs between the two diseases. Classic RA is a symmetrical disease primarily involving the PIP joints and wrists. RA nodules are often present. Psoriasis is an asymmetric disease most often causing "sausage deformities" of the digits, and deformities of the DIP joints of fingers and toes involved with psoriatic nail changes. Typically, skin lesions are associated with Psoriasis. Sometimes proliferative synovitis of the wrists and fingers occur, resembling RA. In these cases, x-rays and laboratory testing help to differentiate the two diseases. Treatment for both conditions are similar, using anti-inflammatory agents, anti-malarials, and adding Methotrexate for stubborn cases. (Answer provided by the late Dr. Raymond Federman, aka Dr. Bones, who passed away on September 2, 2003. The care of his patients even in retirement was always his joy.)
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Date: 03.01.2011
From: Sharon W

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

Hello Nicky,
Thank you very much for that I really appreciate it. I found some similar posts on the internet and what I could not understand is I have aggresive PA and it is indeed symetrical. I have the pain etc... in both my joints and bones on both sides of the body, but I do not have the nail problems. I am wondering if I could have both forms of arthritis R and P. Or has my Rheumatologist just gave the diagnosis of PA because I suffer from Psoriasis. My CRP and Rheumatoid factor was normal, suggesting no Inflamation, in turn suggested no RA but you could clearly see I was balooning all over. The steroids have helped like mad, the swellings are down to a very minimum. The pains are still as aggresive and spreading to each bone each day, but the swelling side of it has reduced like mad. Does anyone think I should get another version of diagnosis, or should I just accept that it is PA??
Thank you very much again Nicky,
Sharon x
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Date: 05.01.2011
From: x kerry x

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

hi sharon, this sounds exactly like me. Ive been diagnosed with pa after xrays and blood tests came back normal. I also have hyper mobility syndrome, making physio for arthritis awkward. I had psoriasis when i was 15 (ten years ago) but only get small patches now, i have no nail pits, but sometimes get tiny bisters on my hands. My joint pain is symetrical, although it seems to affect random joints on either side one day, then the same joints on the other side the next. I have all the typical arthritis pains, cramps, burning, stiffness and visable swelling, but im just still not sure this is the right diagnosis. I feel like ive been palmed off with something that cant be proven, and if im going to adapt my life around this disease, i need to know ive got the right diagnosis. Hope u get some answers xx
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Date: 05.01.2011
From: louloubelle

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

Hi guys

I was diagnosed with PA when I was 9 years old after developing psoriasis aged 7. My PA is referred to as "Large Joint Symetrical Anthropy" and they have never been able to rule out RA. However, the way the arthur responds to certain drugs strengthens the diagnosis of PA - for example, I had a miraculous response to anti-tnf whereas I may not have responded quite as well had it been RA. Mine is also an aggressive form of PA which resulted in me having both hips replaced in my early 20s (I'm now 31). I understand that such aggressive PA isn't all that common although there seems to be an awful lot of people on this forum with aggressive PA so I'm sure you will get a lot of the support you need.

All the best
Lou xxx
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Date: 05.01.2011
From: Sharon W

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

Hello Kerry and LouLou,
Thank you both very much for your help, it is appreciated.

I do get a little worried thinking that I have something else going on inside me, as I never thought that I could be pinned down like this. I have been through a great deal within the last three years and I came out fighting fit etc... but this will not let me win.

I went back to the R Nurse for my fortnight bloods and monitoring etc... Yesterday I was only in the room 2 mins when she said that she would have to inject the steroids into my backside, I asked why when I am on oral steroids and she said that I needed a quick fix as the Methotrexate takes up to 12 weeks to work and I am only on week 5 now. I still have to take my oral steroids until the course ends in 2 weeks.

I asked the nurse if there could be anything else going on and she said no, and people do not realise how bad this can be. I am in pain 24/7 and I am on strong pain meds, I cannot walk hardly because my groin is snapping in half, that is how it feels but the Nurse said it is my hips. My PA started with just niggles in my fingers and my Doctor said I had carpel tunnel, a short while later it was in my feet, now it is in both hands, wrists, elbows, shoulders, knees, ancles, and feet. It is in my hips, lower back and I have terrible pain in my right breast bone, this hurst that much I cry when my son cuddles into me. Can all of this be linked to PA??

My Psoriasis is very mild, I got mine when I was 15 too!! It was very bad at that age but now I only have it on both elbows and knees, I have a random patch here and there but that is it. I thought to have PA this aggressive then the Psoriasis must have to be aggressive too??

I am so sorry to hear that you both have it, and Lou that must have been devastating for you to have hip replacements at that age, I know that is very bad at any age, but you are very young. Please can I ask to what extent you got before they decided that you needed that surgery??

Thank you both very much again,

Sharon xxx
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Date: 05.01.2011
From: x kerry x

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

it really worries me how serious this disease is, i feel like its taking over my life. I had to quit my job because of it which upsets me alot. As well as the pain, i struggle to deal with the tiredness. Even just a trip to the doctors exhausts me and i need to sleep after. Is this the case with everyone else? Also, will my body be able to cope if i get pregnant? I struggle so much as it is, but i really want to have a baby in the next few years, how do you cope running round after kids with pa? I was only diagnosed 2 weeks ago, so i only know what the doctors have told me, id never even heard of pa until then, so im still very naive about it, i didnt think arthritis would be something id have to even consider til i was much older! Thanks for any help in advance x
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Date: 08.01.2011
From: Sharon W

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

Hello Kerry,
I am finding this PA very bad too!!
Everyday I wake up with the pain elsewhere in my body. Yet I have tablets coming out of my ears for it. I was even given an injection for 8 weeks worth of steroids but that has not helped at the moment.

As far as the wanting a baby goes Kerry, I do not think you can fall pregenant on Methatrexate, so if you are on that you would need to stop it. I did read somewhere that being pregenant can actaully reduce or even stop the effects of PA, this is something to do with the hormone changes etc... I can actually vouch for this as far as the Psoriasis Skin problems go, as I have 4 children and everytime I have been pregenant I have not had to use any treatment for the full period, and you would never have known that I suffered from them at all. They did come back within 3 months of delivery, but 9 months free of it was great!! I did not have the Arthritis part of it with any of my pregnancies so I cannot guide you on that sorry!!

Please can I ask when you say Hyper Mobility what do you mean by that??

Take Care, Sharon xx
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Date: 08.01.2011
From: louloubelle

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

Hi Sharon and Kerry

I never had any pain in my hips until I turned over in bed one night in May 2001 and felt a snapping, this was apparantly because the cartiledge that stops the bones from rubbing against each other had been gradually wearing away and finally a hole appeared! The bones were then rubbing against each other and immediately I was in agony and could not bear any weight at all and was unable to move my hip. I had to be put under a general anaestetic so they could remove some fluid from the hip to test for infection because they thought it may have been that as it happened so quickly. It took quite a few days so in the meantime I was put on antibiotics and kept on 24 hour bed rest at the hospital on traction - was not pleasant. I was then transfered to my rheumy's hospital where I had two weeks of physio and hydrotherapy to get me at least a little bit mobile again. I had an mri scan which confirmed my rheumy's suspicions and, I think because of my age, I had the opeartion that September.

The following year, the same thing happened although I wasn't kept in hospital this time and I was booked for hip replacement surgery 5 weeks later! The recovery was swift (about 8-10 weeks) and I have not had any problem since so I have found it all to be a very positive experience.

As for pregnancy, I had my first baby this year (Oscar's now 15 weeks old). I found the first few months really tough. I'd been on anti tnf for 8 years and all of the PA symptoms had all but gone (stick with the cocktails of drug, there may well be the perfect one out there for yuo). My rheumy was happy for me to stay on anti-tnf until conception but the minute I got a positive pregnancy test I stopped the treatment. I was able to keep at work (I'm an estate agent) but would need to go to bed as soon as I got home. As each month passed the PA improved. Unfortunately for me though I've not been able to go back on any medication as I'm having chemo for breast cancer (some of us get all the luck) but with a lot of help and support I'm managing to take care of the baby (you find ways of managing).

I hope that helps
Lou
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Date: 08.01.2011
From: Sharon W

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

Hello LouLou,
What you have gone through and now going through makes me feel bad for feeling so down etc... You have a very positive attitude and that is fantastic. I have had some very horrible things go on in my life and it makes you stronger physically and mentaly, but this PA has sunk me.

Please can I intrude and ask how long you have had the Breast Cancer, and how and why you got diagnosed with it. I know this is the wrong forum for that and you can tell me to go away, I would understand.

You have a 15 week old little girl, I bet she is gorgeous and a little cuttie. My little girl is 19 on Monday. Not so little hey!!

Please accept a hug from me, xx
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Date: 09.01.2011
From: louloubelle

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

hey sharon

no one should ever feel bad about how down they feel just because someone else has been through a lot! PA can make you feel so low; of everything I've been through, the toughest times have been when my PA is flared up. I believe it is important to keep positive, especially when you are having good days 'cos you need to make the most of those days!

Oscar's a 15 week old little boy and he is adorable. It was because of Oscar that I found the breast cancer - he's my little hero. I found a lump while pregnant; my breasts were swollen and sore (I was 23 weeks pregnant) and gave them a little rub as I took my bra off. It was actually a cyst that I found that came up because of the pregnancy hormones. I was treated for early mastitis to begin with and, as it hadn't gone down, persisted (I could have brushed it off as pregnancy problems but I knew it was worth perservering). I was diagnosed at 27 weeks pregnant and began chemo at 29 weeks pregnant. I had two rounds of chemo while pregnant and Oscar was delivered at 35 weeks and weighed an impressive 5lb 7oz and doesn't have any health problems at all. I have my last chemo on 19th January which will be my 8th. I'm then having a lumpectomy and radiotherapy. I caught it early but it is an agressive form. Because of this it has responded really well to chemo and after only 4 rounds of chemo the lump was undedectable on a scan.

I accept you hug, thank you kindly. And hugs to you and Kerry too. I know how hard living with PA is, people don't realise how much it affects your day to day life and how exhausting it is; especially when your joints are first affected.

Take care guys
Lou x
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Date: 09.01.2011
From: x kerry x

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

lou my heart goes out to you, you must be so brave going through all of that, and with a new baby to cope with on top, i really admire your strength.

Sharon, hypermobility syndrome is basically being double jointed, or having shallow joints which have a wider range of movement than normal deeper joints, which leads to the joints wearing themselves out, and the tendons being over used, weakening them, making it harder to support my bendy joints. Ive had it all my life but just thought i was flexible, so pushed myself to do things like gymastics, trampolining and pole dancing, not knowing the damage it was doing to my joints. People with hypermobility are more likley to dislocate their joints, which i just thought was me being accident prone. Apparently my brain doesnt get the signals to tell me how much my joint has moved, so it doesnt send the message to stop the joint from moving anymore, thus forcing my joints to keep pushing. I can be sitting in the most uncomfortable possition for hours, but not realise im causing myself pain until i move. There are other symptoms too, like being fidgety (which i was always getting wrong for when i was younger) and using your joints to support your weight on, instead of your muscles (like locking your knees for example) im having physio to learn how to walk/stand properly, apparently ive been doing it wrong for 25 years so its all a bit strange, and its hard work using muscles i havnt been using. This is about as much as i understand about it so far, but im always finding more out. I think its just bad luck that i have pa on top of this, as they told me they arent linked.
I have been on sulfasalazine for 2 weeks but was told by my rhummy to stop it for a few weeks as it was making me quite dizzy and made my tiredness so much worse. Im going to try it again after 2 weeks to see if my body accepts it a bit better this time. Im affraid if it doesnt that ill be put of methatrexate, putting a halt to my baby plans. But no point worrying about that yet. I have read that pregnancy can make pa symptoms ease but that they can return worse after the pregnancy. I really hope you both all the very best and hope we all find ways of managing these crappy times x
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Date: 09.01.2011
From: x kerry x

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

ive just been thinking about it and i also get a stabbing pain in my breast bone, i had a breast augmentation a year and a half ago and always just thought it was down to that...could this also be the pa? I find resting a hot water bottle on it eases it xx
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Date: 09.01.2011
From: KayJay

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

Hi kerry it could be Costochondritis which is linked to pa and fibromyaglia. Best to check with the gp / Rheumie though.

Link here : http://www.associatedcontent.com/article/558267/what_is_costochondritis.html?cat=70
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Date: 11.01.2011
From: Sharon W

Subject: Re: What is the difference between Psoriatic Arthritis and Rheumatiod Arthritis

Hello Lou,

I am sorry I called your little baby a girl, I must have had one of those empty head days. Babies are indeed a god send. My Youngest son is called Malakai and that actually means "a gift from god" and I tell you Lou there has been no truer statements made.

I am very sorry to hear about your hips, you have gone through a lot in your time. Then you have the BC to deal with also. I am soooooo pleased to hear that your lump is now no longer visible that is fantastic news. How on earth did you keep your mind on the pregnancy, I guess that actaully answers that question in itself, "your pregnancy helped you to deal with that". You are only very young also, I know it is very bad no matter what age, but you have been through more than most people out there in 70 plus years. Your positive attitude has been a major factor in your recovery Lou, you keep it up....

Take Care, Hugs xx
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