The reason I went was to let the doctor know that my wrists, arms and shoulder seemed to be hurting more than normal & that I didn’t think that the mobic I was taking for my Carpal Tunnel (CT) was helping (I did forget once again to mention my hip pain). Once I mentioned this Dr C got me to squeeze his hands and then place my hands together in different positions to check them. He then asked me if I had any test done etc to confirm if it was carpal tunnel and had anyone spoken to me about treatment options that were available. I had to say No tests were done.
While Dr C was checking out my hands he noticed that I have psoriasis and he suggested that I might have arthritis. Of course the first thought in my head was NO NOT Psoriatic Arthritis! He organised for me to have a blood test to check for various markers that would show inflammation levels, liver function, etc and gave me a referral for a nerve conduction study (NCS)

I saw Dr Li all those years ago when I was first diagnosed with CT and he didn’t believe in sending people to see specialists or sending them off to have loads of tests done. Maybe he was mindful of how much money these things could consume as most of his patients were on benefits of some kind. In fact the one and only time I asked Dr Li for a referral to a dermatologist he said I don’t know they are awfully expensive to see. He reluctantly wrote a referral and I saw the derm a few times only but that was enough because the main aim was to get a UVB lamp – which is exactly what I got.

I am now booked in for the NCS on Wednesday Aug 19th in the afternoon. I’m truly not looking forward to is as I have been told that it hurts. I am such a wuss when it comes to pain. Who on earth thought of this blasted test to assess for carpal tunnel anyway? Some kind of torturer? Sending electricity, even in small doses, through the skin/body sounds like torture to me. I am not happy Jan!

Before I get too distracted by the test that I am having I wanted to find out more about Psoriatic Arthritis (PA) & treatment options for it. In some ways I am truly hoping that the diagnosis of Carpal Tunnel is confirmed and that this test isn’t a waste of time. I would really hate for this pain that I am having to be PA. The thought of me having arthritis scares the pants off me. At least CT can be fixed if needs be by an operation PA can’t. The links (Arthritis Victoria) that I did find in regards to PA have been very helpful.

To be honest I shouldn’t really complain about Dr C. considering I have never seen him as a patient before he is being very thorough by sending me off for different tests. It’s a shame that Dr Li didn’t do it all those years ago. It would’ve save me some time in working out where to go to from here. And of course I’ll keep you all updated on the outcomes of the tests. Wish me luck for next Wednesday!!Posted byBlossyat1:00:00 PM

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Stress

climate

infection

skin injury

smoking

Medications

These conditions can create the immune system to breakdown resulting in one of many types of Psoriasis.

 Scalp Psoriasis

The most common form is Scalp Psoriasis occurring in about 50 percent of all patients and it can be one of the most difficult areas to treat. The scales on the scalp can be silvery-white and thick, sticking together tightly to form dense very itchy crusts. Be careful by picking at the scales and scratching the scalp as this can worsen the psoriasis.

Scalp psoriasis can be localized, creating only a few small areas or can affect the entire scalp. The lesions sometimes appear behind the ears and along the hairline, plus they can spread beyond the hairline. If the ear canal is affected with enough scales, hearing may suffer. Hair loss is uncommon as  psoriasis does not affect the hair root, although in bad cases hair loss can happen. Any hair loss usually regrows once the psoriasis is under control.

Small areas of scalp psoriasis that remain hidden by the hair and might not be seen by an one looking; there are forms can be really itchy and highly visible. Silvery-white scales (resembling dandruff) flake onto shoulders , although embarrassing these can create stress for the patient. Successful treatment is vital to control any continued stress and physical discomfort.

Treatment of   http://www.psoriasis-facts-online.com/ScalpPsoriasis.html

Scalp Psoriasis is complex, and many therapies that will help. Occasionally success can be found by trial and error, and it is important to be patient when treating and waiting for results.

Tim Olden is a well known author of Psoriasis Facts, for more information click on:- http://www.psoriasis-facts-online.com/WhatCausesPsoriasis.html

What Causes Psoriasis http://www.psoriasis-facts-online.com/index.html

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Typically, a patient will have had psoriasis for a number of years before the arthritis develops.  A small proportion of patient will develop the arthritis concurrently with the skin disease and an even smaller percentage will develop the skin disease after the joint disease.

Psoriatic arthritis may affect most joints in an oligoarticular pattern, meaning a few scattered joints are affected and the joint inflammation does not have the symmetrical pattern seen in rheumatoid arthritis.  Enthesitis, which is inflammation of the tendons that attach to bone, is common in psoriatic arthritis.  “Sausage digits” – swelling of the fingers and toes so that they look like little sausages is frequent.  Nail changes are also common. These include “pitting” and separation of the nail from the nailbed. Some patients will develop carpal tunnel syndrome because of inflammation in the wrist.  Inflammation of the eyes is a serious complication, as is involvement of the aortic valve of the heart.

Joint deformity is frequent and affects 40% of patients with the disease.  Psoriatic arthritis has a significant impact on quality of life.  The skin disease is a tremendous burden and often leads to depression.

The inflammatory process that causes both the skin disease as well as the joint disease is driven by elevated levels of a substance called tumor necrosis factor, or TNF.

A patient with psoriasis who complains of joint pain, swelling, morning stiffness, and fatigue should raise a high level of suspicion for the diagnosis of psoriatic arthritis.

Laboratory testing will show evidence of inflammation and imaging procedures such as magnetic resonance imaging (MRI) can help confirm the diagnosis.

Treatments that improve the skin disease do not necessarily improve joint symptoms and vice versa.

Treatment goals include symptomatic relief and control of disease progression.

Non-steroidal anti-inflammatory drugs are helpful for relieving some symptoms.  However the majority of patients with psoriatic arthritis will require a combination of methotrexate and anti-TNF biologic therapy.  Anti-TNF therapies have provided a significant advance in the treatment of both the skin as well the joint disease in patients with psoriatic arthritis.
Dr. Wei (pronounced “way”) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of  Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: [ http://www.arthritis-treatment-and-relief.com/types-of-arthritis.html ]Types of Arthritis

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