New diagnosis.....AGAIN!!

[Guest guest]

Hi All,

Had appointment with my rheumy..got new diagnosis..he believes I have rheumatoid

arthritis (RA)..not PsA..but left me hanging that this is very hard to

diagnose..My RA test is negative but have other issues pointing in

that direction..My grandmother had RA and my sister has lupus..also I

have a cousin with RA..so he is also looking at my family history

too..I have Barrett’s Esophagus so we are limited on medications but I

have not been responding to Enbrel alone so he wants to add prednisone

5mg daily..as opposed to Arava..I know both of those could cause

stomach problems..He is also contacting my gastrointestinal (GI) doc to see if

he would

be opposed to either of those meds..I could not tolerate

methotrexate..even the injectable..I have new joint involvement and

new nodules on some of my joints..

Just thought I would update you...Any thoughts or opinions on this is

very welcomed..

Thanks so much..

Vickey

[Guest guest]

Hi Vickey,

Wishing you well, whatever your diagnosis might be.

In reality, many times RA is treated the same way as PsA, so while it

might be reassuring to have a " correct " diagnosis, the treatment is

usually very much the same for both.

I'd still try to get a " correct " diagnosis, but no need to fret as

most likely treatment would be identical.

Stay Well,

[Guest guest]

<<new diagnosis..he believes I have rheumatoid arthritis (RA)..not

PsA..but left me hanging that this is very hard to diagnose>>

When reading this it popped into my mind that when I was diagnosed the

Dr explained that my fingers indicated PA. I have involvement in the

very top joints in my fingers (PA) rather then the knuckle joints at

the base of my fingers(RA). I don't know if this will help just thought

I would throw it out there.

-Eileen

[Guest guest]

My rheumy also is not sure which I have either. My arthritis doesn't

fit either of the categories perfectly. And it is true that the

diagnosis doesn't matter that much because the treatments are exactly

the same. And I bet if I didn't have a family history of arthritis

and I went to another rheumy the diagnosis would change. It doesn't

bother me too much that I don't know for sure. Its just a category

anyway. Its mainly important to insurance coding.

" Sheridan " <sksherid@...>

[Guest guest]

Hi Vickey,  I'm in the same boat.  I originally was diagnosed with juvenile RA

at age 8 and when I was in my early 30s, my diagnosis was changed to PA.  Since

then, my orthopedic surgeon tends to write RA and my rheumy would write PA.  I

just switched rheumys and he's now thinking RA.  I, too, am RA negative but the

severity and the way my joints are damaged, it looks like RA.  I went through a

lot of x-rays this month for which my new rheumy is going to review to help

determine which I have.  I believe the way your joints break down, helps them

diagnose one over the other.  It doesn't matter much to me, as it is what it

is. 

[Guest guest]

Gilchrist wrote:

> Hi Vickey, I'm in the same boat. I originally was diagnosed with

> juvenile RA at age 8 and when I was in my early 30s, my diagnosis was

> changed to PA. Since then, my orthopedic surgeon tends to write RA

> and my rheumy would write PA. I just switched rheumys and he's now

> thinking RA. I, too, am RA negative but the severity and the way my

> joints are damaged, it looks like RA.

It's interesting that they would consider it RA based on severity. My

rheumatologist says that PsA can be very severe. My knees at this point are

totally destroyed and I worry a lot about what is happening in my other

joints.

Gareeth

[Guest guest]

Gareeth, By no means am I suggesting that PA cannot be severe.  It certainly can

and I believe many of the people on this board are here because it is severe for

them.  I didn't mention the other factors because I cannot recall them.  Years

ago when they were struggling between the two diagnosis, I did my own homework. 

One disease may impact more equally on both sides (both knees for example),

while another is more sporadic.  Also, with bone destruction I recall that one

disease wears away in a more rounded fashion, while the other is more

splintered.  You have me curious now and I think it's time again to research the

differences.  My old rheumy used to say that my PA was very RAish.  I suppose I

have characteristics for both diseases.  With that said, I wonder if you can

have both PA and RA.  You can have osteo arthritis and either of them.  Who

knows?  When I go for my second appoinrment with my new rheumy, I'll ask about

it since he's raising  the old RA dx

again. 

[Guest guest]

Somebody correct me if I'm wrong because I haven't researched RA that much but

isn't the primary difference that PsA can affect the body's organs, including

eyes - and not just joints and their associated muscles, tendons, etc.? 

 Joanna Hoelscher

[Guest guest]

I just found this excerpt from an article about RA. I found it on

http://healthlink.mcw.edu/article/1031002895.html

" RA is not just limited to the joints, " says E. Cronin, MD, a

rheumatologist and Associate Professor of Medicine at the Medical

College of Wisconsin. " It can affect other organs: the skin, the

lungs - both the lining of the lungs and the lung tissue itself -

the liver, heart, eyes, nerves, muscles, blood vessels and, rarely,

the kidneys. " By contrast, patients with osteoarthritis do not

experience inflammation of internal organs.

" RA patients with multiple organ systems affected tend to be those

who have what's called rheumatoid factor in their blood, or those

who form nodules on the skin or tendons, the cords or bands that

connect muscles to joints. Blood tests show that about 75% of RA

patients are positive for rheumatoid factor, and about 30% form

nodules, " Dr. Cronin says. "

In other articles I've read, I think that the biggest difference

between the 2 is that PA affects the hand and wrist joints

especially the DIP joints along with the psoriasis.

My son has no problems with his hand or wrist joints, just his ankle

and foot. Go figure that one?

& Grant (11, PsA/Uveitis)

[Guest guest]

Joanne

You are correct. PsA is much more thorough in decimating the entire body. I have

already lost the sight in one eye and my leg tendons are quite inflamed. I don't

know t5he whys but I do know the results and they are not good. God Bless

Walt

[Guest guest]

Joanna, When I was diagnosed w/ JRA at age 8, I needed eye exams.  This was way

before the PA diagnosis.  Therefore, eyes can be impacted by both.

Gilchrist <gilchrist414@...>

[Guest guest]

No- RA is a systemic disease-meaning it does affect the entire body systems. 

The differences btwn RA and PA are subtle.  RA tends to evolve in a more

symmetric fashion (both knees, both elbows, etc.)  But there are exceptions to

both diseases.  Some people w/ PA have symmetrical patterns to.  Also the joints

in the fingers differ somewhat between what is affected by PA and RA.  Again-

there are exceptions.  I know this from researching just this week the

differences of the 2.  I basically googled " comparison of RA to PA " and went

from there.  I would encourage you to do the same.

Hope this helps!