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Psoriatic, Reactive Arthritis or neither?
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Psoriatic, Reactive Arthritis or neither?

Thankyou immensely to anyone that takes the time to read this and give their opinion.

Hi, I am a 19 year old male (20 in june), and have been suffering from a range of tendon and enthesis pains for about 16 months now. Accompanying this has been a generalised mild fatigue, and a range of other non-serious but strange changes to my skin such as purple skin around the joints, a mottled look to my arms and various small white patches in addition to a darkening of the circles under my eyes. I can trace everything back to a sickness in mid-late 2012 which kept relapsing, the main symptom of this was fatigue and general malaise. I seemed to overcome this a few times until it seemed to mostly disappear in December 2012. From this point on I have had tendon pains and joint pains some which were caused by light to moderate physical activity and in no way was this activity more then I had done a few months previous. I had played soccer and run cross country for 11 years before this with a range of standard injuries as would be expected but never any problems with tendons or joints. Currently I have multiple tendon/enthesis pains and a few joint pains, R/L quadricep enthesis, L achilles tendon, L shoulder, L tricep enthesis, R extensor digitorium tendons and entheses, thoracic back pain, and R knee joint. Most of these are currently mild but still hamper my ability to do much. Conservative treatment had some effect for the R quadricep enthesis and the achilles tendon which were both thought of as injuries and were originally the only two problems but were strange and puzzled the physios whom I was seeing for 12 months. I have had 2 MRIs and an xray on the right knee with not much to show for my pain.

I have had stacks of blood tests (testing for everything under the sun) including a short synacthen test and a urine test with absolutely nothing to see. I have seen my GP, a naturopath, a physician and a rheumatologist none of which can give me a definitive diagnosis. The rheumatologist was the most successful visit as he identified the enthesitis which was previously passed off as tendonitis. He identified a small amount of psoriasis on my dad's knee (but hardly anything). I don't have any psoriasis but he has labelled my condition as possibly psoriatic enthesitis and has put me on sulfasalazine. I am obviously willing to try it because nothing else has worked. I was on it for a few days and developed a sore throat and respiratory infection which I thought was linked. However rhuematologist wasn't convinced, ran a blood test which was normal (AGAIN!) and told me to keep taking it. The infection has cleared but a stack of my pains have been worse since then especially my upper back which leads me to wonder if infections and bacteria are the root cause of my problem.

If it is relevant I have had headaches and general neck stiffness since about Grade 11 (2010) and am curious if this can all be traced back to a throat infection (only symptom was a very very sore throat when I woke up but was about 20% of this pain after a half hour) I got on soccer tour in Malaysia/Singapore in Sep-Oct 2010. I am now third year of university and am struggling, to put it plainly.

I have a few questions as I am not convinced, i don't have psoriasis or any abnormal test,
1. Is there anything that could've been missed such as a vitamin, mineral deficiency or something else that causes weakened tendons/entheses?
2. Is this a case of Psoriatic Arthritis or Reactive Arthritis or is there another possible explanation? Or is this just unexplainable given all my normal tests. These two conditions give a negative rheumatoid factor but don't these conditions have other signs in the blood?
3. Can a course of antibiotics 'magically' fix a condition like this? Or is there tests to test for any lingering bacteria/infection?

I can get a list of everything that was tested for but it included every test 'inside the box' related to this condition and also ruling out a bunch of 'exotic' conditions as the physician put it.

Thankyou again and sorry that this was so long I just really need as much help as I can get at the moment.
  So sorry that you are suffering this way.  It must be a real frustration for you.
     A Potassium deficiency can cause your symptoms.  But you also need to take Magnesium to utilize it properly.
    Vitamin D3 also is very important as many of us have a deficiency and it isn't recognized unless the parathyroid is tested.  
     You might try taking some of these supplements and ask your doctor for tests for:  iron levels, potassium, magnesium, vitamin D3,  and Vitamin C.    Oftentimes these are not "caught" as the doctor has to order special tests if viruses or infections are not present.

     If you have taken antibiotics at any time - you probably are also lacking good bacteria in your gut.  Antibiotics kill all bacteria, good and bad.  We need the good bacteria to stay well, healthy and to digest our food properly.

    Hope this was helpful.  Wishing you the best

    A deficiency can even cause a fever.   Just saying...

Definitely take magnesium 500 mg every morning.  If you take calcium, take it separately from the mag, about 400 mg at night.  Vitamin D3 you can take 1000 or 2000 IU.  

But I would also check to see if it's a match for Lyme disease.  I don't know a lot about that, but I sure hear a lot of people having problems with it.  
What specific blood tests were run by your rheumatolgoist? Something that can occur post strep infection especially in young people is Rheumatic Fever. It can cause joint pain and stiffness. Sometimes it can affect the liver etc.
Did your rheumatologist happen to check you for Hepatitis?
I will need more specific information regarding your blood work to help you. I am a patient advacate and my specialty is helping folks with chronic, complex issues navigate through the system.  Do you have a copy of all of your blood work and the radiology reports from your MRI? If not, get copies of all your bloodwork, Radiology reports (you shouldn't have to pay for them and if you do it should be minimal) Also, get a copy of your last "well person" blood panel prior to the onset of this condition if you have any. If you don't have any well person labs prior to onset of your condition, any labs you might have prior to condition onset would be useful. You can contact me at tristan dot moore at hotmail ******* or tristan93 at me *******.  I will send you a written acknolwedgement of protecting your privacy.
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