Help me understand PSA and enthesitis
51/f here and 5 years ago I underwent months of physical hell before being diagnosed with PMR by Rheum #1. Elevated CRP and ESR.
Pain began literally overnight in shoulders and upper arms/biceps. After a few days, I couldn’t lift my arms. This continued for months while doctors tried to figure out what was going on. By the time I got in w Rheum it had progressed and by the time he diagnosed it PMR, I was practically bedridden. I’d been taking high doses of Aleve for months and even prescription painkillers did nothing. Within 36 hours on 20 mg prednisone, I was practically perfect again. All was well. No pain and I could move normally.
Rheum1 left the area and I saw rheum 2 who put me thru all the paces before reluctantly diagnosing me with PMR (I am young for this diagnosis but it’s not unheard of). I saw Rheum2 for 4 years while tapering on prednisone but never quite able to get fully off without a flare. Rheum2 closed their practice.
Rheum3 walked into the room really arrogantly and told me he refuses to diagnose anyone under 50 with PMR. He told me I have enthesitis type PSA. He checked my fingernails and put things in my visit notes that were not accurate.
I’m very confused and honestly just want a true diagnosis. My symptoms have always been so incredibly textbook PMR and everything I read about PSA and enthesitisis just doesn’t seem to fit my symptoms and experience.
Can anyone with this type of PSA shed some light? I feel like he diagnosed me more as a refusal for PMR than because of PSA symptoms.
Thanks for taking the time to read all this.