Shoulder, knee, wrist and finger pain, itching skin

Hi Wedgyjackson,

You are correct about the difficulty of getting an autoimmune diagnosis. You may be in for a long ride...Take a deep breath and try to focus on what body parts still work well for you.

Two things in your post seemed odd to me. (I am a patient, not a doctor.)

1. It seems a little strange that your ANA should go down and also change patterns. I am not a doctor, though.

2. Your PCP and your rheumatologist NOT in agreement on your medication.
This doesn't seem like a good situation to me. Ideally, all of your doctors should agree on your treatment.

You may want to either change your PCP or change your rheumatologist. I always ask my PCP to give me the name of specialists that the he knows and recommends. He recommended my rheumatologist-- who is fantastic. He never disagrees with her.
When my PCP's office was in turmoil due to corporate changes, I asked my rheumatologist for names of PCPs. But I never did have to change my PCP.
_____
The doctors' office staff can be really important to your care, depending on the rules of your health insurance. My previous insurance had all kinds of rules, and my PCP's staff knew how to navigate those rules. Some of my specialists' offices did not know, and it caused delays and stress and all kinds of stupid irritations.

It's good that you have found this website. I recommend reading the information in this patient site AND also-- more importantly-- the Mayo Clinic site. The Clinic site has information from doctors. This site has anecdotal information from patients, which can be helpful but not always the clearest or most objective.

Best of luck to you! Keep us posted on your progress.

@wedgyjackson
Welcome to Mayo Connect!
Regarding your joint pains- were X-rays done on any joints- knees, wrist, fingers? You mentioned that the rheumatology fellow assumed you had osteoarthritis- did he look at X-ray?
ANA results of 1:40 and 1:80 are considered weak positives for antibodies. It can mean that you are in very early stages of a disease or even no disease.
With autoimmune diseases diagnosis can take a while because symptoms come and go.
Your PCP could follow you- examine your painful joints and
repeat blood tests as needed.
Did you speak to your PCP regarding taking Celebrex?
If you need to see a rheumatologist again, request to see the specialist and not the fellow.

Thanks, I really appreciate all input and advice. I am probably a little prematurely anxious on this diagnosis process. I just saw the fellow at Rheumatology on Tuesday and I received the lab results online, so I haven't consulted with the Rheumatology dept about what they mean yet. We have no rheumatologists in my town so my PCP had to refer me to a practice over 1 hour away. It took me a full month just to hear from them and then they had an appt available the next day. I felt so lucky and excited to get in that quickly until I found out the doctor I was seeing was a fellow. I actually liked him and he spent plenty of time with me but I think I would benefit from a rheumatologist with more experience. He seemed convinced I am suffering from osteoarthritis and I felt he only ordered the labs to go through the motions. He even set me up for injections in my knees before the lab results were known. I don't plan on getting that done until I know more.
In answer to your questions, I also thought it odd that the ANA results were lower and a different pattern. I do realize both readings are only slightly high. As to the Celebrex, he was ready to write me a prescription also before the lab results were in and I was the one who told him I wanted to consult with my PCP first. I agree that my care team should all be acting together and that didn't impress me either. I am very happy with my PCP and any changes will be specialists.

I appreciate the comments @astaingegerdm! No recent x-rays were done. He did have access to x-rays of my right knee done in 2020 when I suffered a torn meniscus. I did think it odd that he was prepared to administer "knee injections" after no more that a cursory exam.
I am probably a little premature in posting as I received the lab results online and plan on consulting with rheumatology next week about what they mean.
I will insist on seeing a more experienced rheumatologist as I feel the experience is critical in the diagnosing stage.
If the rheumatology folks tell me they have done all they can and still are not sure what is going on, I will definitely set up an appointment with PCP as next step.

@wedgyjackson Everyone is correct, it can take a long time to finally get a diagnosis. I included 2 links to organizations that work with autoimmune patients. One is through the National Institutes of Health and the other is a private patient-centered organization.
https://rarediseases.info.nih.gov/
Both offer much information and will help you find rheumatologists (closer than 1 hour away).
https://rarediseases.org/

Why doesn’t your PCP want you to take NSAIDS?

@becsbuddy , I have high blood pressure and take Metoprolol to control it. (Also have supraventricular tachycardia and pvc's) She might prescribe an nsaid if the benefits out weigh the side effect risks. I would just want to consult with her before getting it prescribed from specialist.

Welcome to Mayo Connect! I want to just caution you that rheumatologists are not likely to diagnose anything early on. They like “to watch” things and like to see LOTS of evidence of a condition before making a commitment to a diagnosis. This can be very frustrating but in the meantime your symptoms can be treated. I also wonder why your PCP doesn’t want you to take NSAIDS. They can be very helpful. It’s normal for the ANA to fluctuate in levels but it doesn’t correlate to symptom severity. Inflammation can involve histamine release, which can cause itching and should respond to an antihistamine. Claritin and Allegra are OTC and “nondrowsy “. Generics of both are fine, cheaper. Allegra is stonger IMO. If PCP is ok with NSAID after reconsideration, Naproxen OTC is good for the joint pain. Twice a day with food. I think you need followed by a good rheumatologist who will do a thorough lab workup and repeat as needed. They are sometimes thrown off by males exhibiting AI symptoms since things like lupus and rheumatoid arthritis are much more common in women. I wish you luck and hope you feel better with treatment. When you see the rheumatologist go prepared with a complete symptom list, family history and all previous lab and any imaging results.