Hi, This was by far the worst flare that I have had with the Psoriatic Arthritis. I've battled psoriasis since I was a teen and no one ever found a cause for it nor for several other things that I've battled with over the years. All of my ANA tests came back showing nothing and until the flare mentioned above no one took me serious enough regarding my symptoms. Many of us know how this goes. So, I will always count that horrible flare and excruciating pain as a bitter blessing. The poor doctor told me that it was the worst 10/10 pain score he had personally ever witnessed and was at a loss until the other doctor helped him out with the iburprofen cure for it. Both he and I learned something from it. So, no matter how many years you must battle in finding a reason for your pain and afflictions, stick with it. Many doctors and medical professionals may shrug it off but at some point a reason may be found. I wish each of us the best in life and may no flares come anyone's way.