RE: PA versus RA

[Guest guest]

In a message dated 07/10/2001 2:18:55 PM Eastern Daylight Time,

1385-903@... writes:

<< could anyone please explain the difference in symptoms between PA and RA?

Thanks in advance, Brigitte >>

Hi Brigitte - from what I know, RA has a blood test the you will show

positive rheumatoid factor if you have RA. If you have PA, it won't show.

There is no blood test for PA, they just rule out everything else. Also, RA

almost always attacks both joints on opposite sides of the body

simultaneously, for example, both knees, both wrists, both feet, etc. flare

at the same time. With PA, there is not necessarily the symetry. One knee

or one foot might hurt and the other might be fine.

[Guest guest]

Dear All (same question as Brigette)

I recently went for a blood test and the nurse had written on it RA, I was

told I had PA some years ago, now I am wondering has it now become RA? I

must ask next time. But I too would like to know the difference and how can

you tell if you might now have one and not the other. Also are people who

have PA then more likely to go on to have RA (and which is worse??).

Thanks

(UK)

[Guest guest]

Hi Everyone

Thanks to all who replied with their thoughts on my recent post

regarding Possible PA as opposed to sero neg RA.

The areas of affected skin are tiny, but as many of you think it

could be PA, I have been reading up on it. I must say that none of

the various forms of arthritis common to PA seem to match mine. Mind

you, neither do I fit the RA mold. From what I can gather the most

common form of PA tends to affect the ends of the fingers and toes

and other small joints. Like PA my affected joints aren't

symetrical, which is another reason to doubt the RA diagnosis, but

the ends of my fingers and toes aren't affected at all. My worst

affected joints are my right hip and knee and my right thumb joint

nearest the base, and my left shoulder and elbow, left shoulder

blade, and the tissues of my left foot. My leg muscles are also

badly affected and feel very tight, really rock hard considering I

hardly get any exersise, and my tendons are prone to pull easily.

I will mention the skin flaking to my rheumie when I see him next

month, but as there doesn't seem to be any difference in the

treatments, I don't suppose the name-tag really matters all that

much. I guess without a positive Rheumatoid Factor, diagnosis is at

best an educated guess and at worst a desperate attempt by the

rheumie to put a name to it for the patients benefit.

Thanks once again to everyone who took the time to write.

Lindy

[Guest guest]

Hi and Marti,

I noticed you mentioned that you have read that RA is considered more severe

than PA. My rheumatologist told me it is normally just the opposite. He

said that PA is more painful due to the inflammation of the tendons and

muscles. He is currently a professor at one of our state universities, so I

hope he knows what he is talking about. I had to see 5 rheumatologists

before seeing him and finally being told I had PA. He seems really on top

of current studies and is very good at explaining things. I don’t want PA

to be worse than RA, but it upsets me too when I read that PA is considered

mild compared to RA and I’m in chronic pain every day. Hopefully, as they

figure more things out about PA they will realize just how painful and

disabling it can be.

Maybe once they finally have test for PA they will also realize more people

have this then they realize and it will become more “real” to some doctors.

I also agree with you Marti that you don’t need swelling to have joint

damage. My jaw joint is almost gone and I hardly had any swelling at all.

I will say, I’ve had more than my share of pain in that joint. It still

bothers me and I’m holding off on replacing the joint as long as I can. The

surgeon I’ve seen has told me to go as long as possible, since surgery in

that joint is not always successful at decreasing the pain. Right now I’m

hoping starting Humira will make the difference and stop any further damage.

Take care and I hope both of you are having a good day. Sincerely, Fran

[ ] Re: PA in remission & at my wits end

---Hi ,

I know it can all be confusing. Traditionally, it is thought that the

swelling is what causes the damage.

Almost all the medical people I have seen think this. No

swelling..no damage. All I can say is this was not my experience.

Early in my disease I had huge amounts of swelling along with some

damage. Later, I would get the bad pain but not the bad swelling.

Unfortunately, my joints continued to deterioate. I didn't really

just wake up one day and discover it..I could tell I was able to do

less and less with my hands. And I have not experienced no pain...I

was complaining of pain when I was told I was in remission but

obviously wasn't.

If your rheum is OK with how you are handling your pa does he/she

propose to do x-rays every so often? That could catch damage and let

you know you need to change your approach.

Good question why ra is considered more serious than pa. Again, in

my case,the pa is very serious and it frustrates me to read over and

over that pa is a mild form of arthritis.

I think Dr. Ritchlen is maybe doing more studies on pa than have ever

been done and will eventually get some different information out

there. According to the medscape article someone referred us

to....he is already saying that pa is more prevalent and more severe

than used to be thought. He also said there were some epidemiological

studies under way. This could change the info being sent out to the

docs.

I was interested in Dr. Ritchlen's pictures of the TNF and the

disease process....early on the TNF cells were in the synovial

lining...later in the disease they had moved into the bone itself.

Purely conjecture on my part...but I wonder if that explains my

experience with swelling.

I always try to close with saying I have the mutilans subset and it

is considered rarer than the other forms of pa and more

damaging....so all patients will surely not have the bad luck I have

had. that...and one thing we all know here is this is a mysterious

and unpredictable illness.

don't know if any of this helps...you ask good questions.

Best,

Marti

P.S. How is the soccer? still able to play?

Please visit our Psoriatic Arthritis Group's informational web page at:

http://www.wpunj.edu/pa/ -- created and edited by list member

aka(raharris@...).

Also,in August 2001,list member Jack aka Cornishpro@... began

to conduct extensive research which he publishes as the " Psoriatic Arthritis

Research Newsletter " , monthly in our email and digest format. Many thanks to

Jack. Back issues of the newsletter are stored on our PA webpage as well as

the archives of the list.

Don't forget that the list archives comprise a tremendous amount of

information (Over three years of messages and answers).Feel free to browse

them at your convenience.

LET'S HEAR FROM SOME OF YOU LURKERS out there! If you have a comment or

question, chances are there is a person who has been around a while who can

help you out with AT LEAST an educated guess for an answer! If not,we can

steer you in the right direction with a good website to go to,

Blessings and Peace,

Atwood-Stack, Founder

Alan , Web & List Editor

Jack , Newsletter Editor

Pat Bias, List Editor

Ron Dotson, List Editor

Orin, List Editor

, List Editor

and any others who help in any way (thank you!)

[Guest guest]

Hi Fran,

Thanks for your comments. You always have something good to

contribute. Good for your rheum for recognizing how painful pa can

be...let's see; can he write my rheum??? lol!

I am glad you filled us in about your jaw. I have been diagnosed

with pa there but never thought to ask for an x-ray or thought it

might deteriate like my other joints. It's something for me to keep

an eye on.

Sure hope the humira helps you and that you can tolerate it!!!!!

Hope you also have a good day,

Marti

[Guest guest]

Dear Marti, I just posted a letter to Janet about Humira and how I reacted

to the first two shots. The best thing so far has been a decrease in my

joint pain of at least 60%. That is remarkable for me since nothing has

helped me in the past at all. I also noticed the fatigue was gone for the 3

days I felt really good. Unfortunately the first shot only lasted about 3

days and then the pain was back. I just injected the 2nd shot a few nights

ago and the pain is already letting up again. I was to the point where I

could barely walk with all the bone spurs in my feet and now I'm walking

barefoot without hardly any difficulty. That is wonderful for me.

My only problem has been burning red skin on my hands and face. I already

have erythromelalgia which is burning skin, but the shots do seem to

increase the pain and the redness. I'm going to call my doctor on Monday

and ask him if this is anything to be concerned about. I sure don't want to

give Humira up since I finally have found something that I believe is going

to work. The burning skin isn't fun though and it's so bad on my lips they

are cracked and bleeding. I've been using cold gel packs and they help

along with pain medication, but it sure would be great to not have to deal

with this part of the injection. I was wondering if anyone else has had

this type of reaction to Humira. I also noticed both times with the

injections I didn't sleep for one night. I felt really hyper and last night

had the shakes for about 1 hour. That was a new experience for me. Since

I've only had 2 injections it's hard to know if these are reactions or just

" regular-strange " occurrences for me. I guess I'll keep finding out with

each shot.

Are you on Humira now?

As far as your jaw goes, do you have pain in the TMJ joint? Do you notice

noise when you eat or chew? Do you get headaches or neck spasms? All of

those are signs of TMJ. It sure wouldn't hurt to have it x-rayed. I think

my jaw joint is so bad because when I fell that was the main trauma area and

I also grind my teeth when I sleep. I've used all sorts of mouth pieces and

devices and have found that nothing works the best of all. I do worry about

my teeth wearing down and I worry about the jaw joint all the time. I sure

don't want surgery again on my jaw when the last time was such a disaster.

My jaw is to the point now where it is ankolosying (fusing together) and if

and when that happens I know I will be forced into surgery. That's another

reason I'm praying the Humira does the job. TMJ pain is one of the most

miserable pains I think I've ever had. It's like having a facial migraine

24 hours a day. It really can drive you mad. I've said it before, but I

wouldn't be here if I hadn't found pain management to help me deal with my

jaw pain. I wouldn't wish it on my worse enemy. So I hope you don't have

it too bad or at least it is only a mild case of TMJ.

Thanks for writing and for being so positive. It's hard to stay " up " with

this disease, but I'm trying. Take care and keep in touch. Sincerely, Fran

[Guest guest]

> could anyone please explain the difference in symptoms between PA

> and RA? Thanks in advance, Brigitte

BRIGITTE, HI. A GOOD SITE TO CHECK IS MEDICINENET.COM OR WEB MD. THEY

CAN GIVE YOU A VERY DETAILED EXPLANATION OF BOTH PA AND RA. MARYLOU

[Guest guest]

>

> Hi VJ,

> I was initially diagnosed with PA, then my Rh factor kept

increasing up to 110. So my rhuemy calls it PA/RA. The treatment has

been the same though. I was initially on MXT, then last August

started on Sulfasazaline.instead. I noticed more improvement in pain

reduction after that but this year I have really battled depression

and the pyschaitrist has tole me sulfaszaline can also be linked

with depression although I do have a strong hereditary background of

depression.

>

> So at the moment I would like to try going off it to see if I

might be in remission but I can't get into my rheumy before she goes

overseas for 2 mths.

>

> has anyone come off sulfa.. Do you need to come off it slowly? I

would really like any replies if any of you have had experience

coming off it.

> Thanks,

> Annette

> Annette Small

>HI ANNETTE, I HAD TO COME OFF SULFASAZALINE WHEN IT STARTED

BOTHERING MY LUPUS. I JUSTE STOPPED. IT'S NOT LIKE STEROIDS WHERE

YOU HAVE TO COME OFF SLOWLY YOU CAN STOP. I DID HAVE TO START

ANOTHER MEDICATION THOUGH (PLACQUENIL) AND BETWEEN THAT AND

SALSALATE I CAN USUALLY KEEP MY SYMPTOMS UNDER CONTROL. GOOD LUCK

MARYLOU