Hello, the horizontal dips in your nails that you describe are different from the nail pitting I have. The nail pitting is like several tiny dot-shaped depressions in all fingernails.

I do not have all of the possible signs and symptoms of psoriatic arthritis, but the ones I do have are nail pitting, joint pain in fingers (they imaged my hands because of this to distinguish from osteoarthritis, and it is also not typical of RA), ankle pain, foot pain, plantar fasciitis, lower back pain, and a negative rheumatoid factor test.

Good luck with your appointment!

That’s what happened with me, too. My primary physicians never figured out my joint pain, and then the first time I went to a dermatologist, they noticed the pitted nails. Rheumatologist after that, and I had other signs of PsA.

I’m sorry to hear that. The joint pain really is hell indeed. Started when I was a kid.

Sorry to hear you’ve had so much trouble. That really sucks. I’ve had joint pain since I was a kid, and it got worse throughout adulthood. Finally in my thirties, I got diagnosed with PsA because my dermatologist noticed my nail pitting. Then I went to a rheumatologist. I had other symptoms as well.

I think some infectious diseases worsen psoriasis but aren’t the cause of it. It is believed to be genetic, and the cause is not well understood.

Sure, but I wanted to clarify for anyone reading the comments that you can have psoriatic arthritis without psoriasis. That is part of what makes PsA hard to diagnose and to distinguish from RA.

I believe you that there are tests for inflammatory markers, but there are also antibody tests, including RF. Here is a quote from rheumatoidarthritis.org:

> “In most cases of rheumatoid arthritis, the patient tests positive for rheumatoid factor (RF) and/or anti-citrullinated peptides (CPP) antibodies.”

They have a whole page about the RF blood test, so I don’t know what else to tell you. I’m not a physician.

It is possible to have psoriatic arthritis without any psoriasis rashes on your skin, which is the case for me. Nail psoriasis, such as pitting in your nails, is another sign and there are others.

They most certainly do perform rheumatoid factor tests. I had those tests done for it. I realize that’s not the only tests though. But my point anyway was about distinguishing PsA from RA, not how to diagnose RA.

There’s also psoriatic arthritis, which is worth mentioning because it can seem like rheumatoid arthritis. In fact, testing negative for the rheumatoid factor is one of the ways to help diagnose psoriatic arthritis and distinguish it from RA.