Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group I think I know what my son has. Opinions??

I think I may have and idea what is wrong with my son.
Some of you may remember me posting about him and he even posted on here for a little while. But I think I have it??????

Symptoms/dx and bloods.
It all started with him complaining of back pain regularly at about age 9. At times it was so bad he had to take days off from school.
He then developed a strange scaly rash around his chest and back. Scrape swabs of the area showed no bacteria/infection and it cleared up on its own so we never followed it up.

Then the pain and swelling in his knees and ankles started at about 10-11yrs of age. Diagnosis was osgood sclatters, Siding larsens and severs disease. He had to reduce his sport to only swimming and wear a "moon boot" on his foot alternating between left and right foot every 6 weeks for almost a year.
It did help a little but as soon as he stopped wearing it the pain has returned and now his knees swell up like a balloon at times.
He also has a finger with a marked arthritis type lump in the knuckle and he can't physically straighten the finger completely.

Blood tests were done.
ANA- Positive
RA- Negative (very top of normal range)
HLA-B27- negative
So far doctors suggest dx of juvenile Arthritis.

For the past few years I have thought he has suffered from bad dandruff but on closer inspection he has sores all over his scalp. Some have a crust but most are red and inflamed.

I think I have a diagnosis that could sum up all of his symptoms but would like to see what you all think could be going on and is there any tests that can be done to confirm.

Background info. I am HLA-B27 positive with AS dx. My older daughter is HLA-B27 positive, RA positive with a dx of Juvenile AS and RA. Multiple relatives with similar immune system complaints/dx.
Edit to include: My cousin is covered head to toe in eczema/psoriasis.
Thanks.

Psoriatic Arthritis springs to mind, am I close?

BINGO
That's what I am thinking. Seems so obvious now. Are there any tests as such that can be done or is more a symptom based dx a bit like AS has a combination of symptoms/bloods etc?

Trish,

Psoriatic arthritis? The scalp is the second most common place to have psoriatic plaques. The first is the natal cleft..... which may be a bit more delicate for a mum to inspect - aka the division of the buttocks.....

Louise. WOW now that you mentioned it as a small boy he often had a real problem at the top of his bottom in the little grove. It would get inflamed red and very sore. My doctor them would give us a steroid cream to use it it would clear it up nicely.

How could I be so blind for so long?

Psoriatic Arthritis is bloodwork negative apart from possibly general inflammation markers getting high afaik.

It's dx'ed on the basis of presence of Psoriasis, and swollen joints (swollen joints with fluid in them is typical for PA.)

Oh, and btw: check these areas for more signs of Psoriasis:

Knee joints; slightly below the front of the knee, and sometimes the backside of the joint.

Elbows; right on the joint

Upper arms; Scattered

Behind the ears

Both sides of the groin (generally psoriasis thrives in skin folds)

Neck

Head (already mentioned)

Heels and toes.


Oh and this one is pretty important: Check his fingernails and toenails: If they present with "pitting", it's a very clear indicator for a rheumy.
Pitting is when you inspect the nails closely and find small pits (they look excactly like that) in the surface. They are a sign of inflammtion in PA.

Ok thanks for that will check his nails. I did a little research this morning and it suggests maybe a link with HLA-B8 and severity so I will ask my GP about this.

My mom has psoriasis, I have AS but I also have some psoriatic symptoms. It doesn't matter as they are both treated the same way. because psoriatic arthritis is a spondyloarthropathy as well.

I was diagnosed with psoriasis when I was 18 - had flairs every 7-10 years. My rheumy would not diagnose me with PsA until they seen some Psoriasis - when they seen pitting of my nails - two years ago now - I was finally diagnosed. I am having a Psoriasis flair the last 3 months. So I have been diagnosed with Psoriatic arthritis (2011) with Spondylitis (2009 My SI joints are fused I am HLA B27+.) or as my rheumy said AS with Psoriasis. He said the medication is the same - for me that is NONE.

Hugs and Kisses
Gerri and Makaylah (tail is waggling)