银屑病关节炎

银屑动脉关节炎（对不起的Attik Arth-ry-tus）会导致关节内外的疼痛，肿胀和僵硬。

我t usually affects people who already have the skin condition psoriasis (sur-ry-a-sis). This causes patches of red, raised skin, with white and silvery flakes.

有时人们在牛皮癣之前患有关节炎症状。在极少数情况下，人们患有银屑病关节炎，从未有任何明显的牛皮癣。

银屑病关节炎一个d psoriasis are autoimmune conditions. Our immune system protects us against illness and infection. In autoimmune conditions, the immune system becomes confused and attacks healthy parts of the body.

Both conditions can affect people of any age.

据估计，大约五分之一的牛皮癣患者会出现牛皮癣关节炎。

People with psoriasis are as likely as anyone else to get other types of arthritis, such asosteoarthritisorrheumatoid arthritis。These conditions are not linked to psoriasis.

银屑病关节炎是一种脊椎关节炎。这些是一组具有类似症状的疾病。

银屑病关节炎会导致体内多种症状。人们通常会有两个或多种症状，并且它们的范围从轻度到重度。

One of the main symptoms is pain, swelling and stiffness because of inflammation inside a joint. This is known as inflammatory arthritis.

我nflammation is normally a useful tool of a healthy immune system. The body sends fluid, mainly blood, to a part of the body to fight off infection. But when someone has a type of inflammatory arthritis, inflammation can cause pain, swelling and stiffness in joints.

任何关节都可以通过这种方式受到影响。最常见的关节是：

• 脖子
• 背部
• 肩膀
• elbows
• wrists
• fingers
• knees
• 脚踝
• 脚趾。

关节刚度通常是早晨的第一件事，并且可以持续30分钟以上。休息后，您可能会感到僵硬。

银屑病关节炎can cause connective tissue called entheses (en-thee-seas) to become inflamed. Entheses attach tendons and ligaments to bones. When they become inflamed it’s known as enthesitis.

Enthesitis pain can spread over a wider area rather than just inside a joint. Affected areas can feel tender if you touch them or if there’s just a small amount of pressure on them.

我t commonly occurs in the feet. This can happen at the back of the heel or on the bottom of the foot near the heel. In some cases, this pain can make standing or walking difficult.

The knees, hips, elbows and chest can also be affected by enthesitis.

People with psoriatic arthritis can have swollen fingers or toes. This is known as dactylitis (dak-till-eye-tus), or sausage digit, to describe how whole fingers or toes swell up. It most commonly affects one or two fingers or toes at a time.

也可能导致疲劳，，，，which is severe and persistent tiredness that can’t be cured with rest.

What are the symptoms of psoriasis?

There are different types of psoriasis. The most common is chronic plaque psoriasis. This causes patches of red, raised skin, with white and silvery flakes.

我t can occur anywhere on the skin, but most commonly at the elbows, knees, back, buttocks and scalp.

牛皮癣会在手指和脚趾指甲中引起小圆凹痕，这被称为斑点。指甲也可以改变颜色，变厚，指甲可能会从手指上抬起。

Can psoriatic arthritis affect other parts of the body?

Having psoriatic arthritis can put you at risk of developing other conditions and complications around the body.

获得其中之一的机会很少。但是，如果您有任何疑问，请了解他们并与您的医生交谈。

眼睛

Seek urgent medical attention if one or both of your eyes are red and painful, particularly if you have a change in your vision. You could go to your GP, an eye hospital, or your local A&E department.

这些症状可能是由称为葡萄膜炎的疾病引起的，葡萄膜炎也称为Iritis。它涉及眼前的炎症。

This can permanently damage your eyesight if left untreated.

Other symptoms are:

• blurred or cloudy vision
• sensitivity to light
• 看不到视野方面的事物 - 被称为外围视力的丧失
• 小型形状在您的视野中移动。

这些症状可能突然出现，或者几天逐渐逐渐出现。它会影响一只或两只眼睛。可以用类固醇有效治疗。

心

银屑病关节炎会使您患心脏病的风险略高。您可以通过以下方式降低风险：

• not smoking
• staying at a healthy weight
• 定期锻炼
• eating a healthy diet, that’s low in fat, sugar and salt
• not drinking too much alcohol.

These positive lifestyle choices can help to improve your arthritis and skin symptoms.

如果您对心脏健康有任何疑问，请与您的医生交谈。

克罗恩病

克罗恩病是消化系统的一部分发炎的疾病。如果您有任何这些症状，请去看医生，尤其是如果您有两个或更多症状并且它们不会消失：

• blood in your poo
• diarrhoea for more than seven days
• 定期疼痛，胃部疼痛或抽筋
• fevers
• 一个general feeling of being unwell
• 无法解释的体重减轻。

Non-alcoholic fatty liver disease

非酒精性脂肪肝疾病（NAFLD）是一种用来描述肝脏中脂肪积聚的某些疾病的术语。这不会在早期引起问题。但这可能导致肝硬化（Sir-OH-SIS），这是肝脏变得疤痕并可能停止正常工作的时候。

See a doctor if you have:

• extreme tiredness
• pain in the top right of the tummy, which can be dull or aching
• unexplained weight loss
• 皮肤和眼睛发黄，称为黄疸
• 皮肤发痒
• swelling in the legs, ankles, feet or tummy.

有关特定症状的更多信息，请参阅Psoriasis Association一个d牛皮癣和银屑病联盟。

您从父母和祖父母那里继承的基因可能会使您更有可能患上银屑病关节炎。如果您的基因使您有这种情况的危险，那么以下基因可能会触发它：

• 一个infection
• 一个一个ccident or injury
• 超重
• 抽烟。

There is also an element of chance, and it might not be possible to say for certain what caused your condition.

Psoriasis and psoriatic arthritis are not contagious, so people can’t catch it from one another.

尽快开始正确的治疗将为您提供控制关节炎的最佳机会，并最大程度地减少对身体的损害。

银屑病关节炎可能会有很大的变化。这使得很难就您的期望提供建议。

它通常会对您的出现能力和生活质量产生一定的影响，但是治疗将减少其影响。

银屑病关节炎can cause long-term damage to joints, bones and other tissues in the body, especially if it isn’t treated.

如果您的全科医生认为您患有银屑病关节炎，则需要查看rheumatologist。这些是对疾病的特殊知识的医生。

没有特定的测试来诊断银屑病关节炎，因此将根据您的症状和医生进行身体检查进行诊断。告诉您的医生，您的家庭中是否有牛皮癣或牛皮癣病史。

我f you’ve developed psoriasis in the past few years, and symptoms of arthritis have started more recently, this could suggest it’s psoriatic arthritis. But it doesn’t always follow this pattern.

我t can sometimes be difficult to tell the difference between psoriatic arthritis and some other conditions, includingrheumatoid arthritis，，，，osteoarthritis一个dgout。

诸如类风湿因子和抗CCP抗体等血液测试可以帮助您。银屑病关节炎的患者往往没有这些抗体。患有类风湿关节炎的人更有可能对其进行呈阳性 - 尤其是如果他们持续一段时间患有类风湿关节炎。这些测试无法确定某人是否患有银屑病关节炎，但是在考虑其他所有内容时可以提供帮助。

X-rays of your back, hands and feet may help because psoriatic arthritis can affect these parts of the body in a different way to other conditions.

Other types of imaging, such as ultrasound scans and magnetic resonance imaging (MRI), may help to confirm the diagnosis.

You’re likely to see a team of healthcare professionals.

Your doctor, usually arheumatologist，将对您的整体护理负责。专家护士可以帮助监测您的病情和治疗方法。称为皮肤科医生的皮肤专家可能是负责牛皮癣的治疗。

您也可能会看到：

• 一个physiotherapist，谁可以建议进行练习以帮助维持您的流动性
• 一个职业治疗师，，，，who can help you protect your joints, for example, by using splints for the wrist or knee braces. You may be advised to change the way you do some tasks to reduce the strain on your joints.
• 一个足病医生，，，，who can assess your footcare needs and offer advice on special insoles and good supportive footwear.

Because there are several features of psoriatic arthritis, there are different treatment options. Some of these are just for symptoms, such as pain and swelling, while some can treat the condition itself and reduce its symptoms.

人们对特定治疗的反应有所不同，因此您可能需要尝试一些选择来找到适合您的方法。

Types of treatments

For the arthritis:

• non-steroidal anti-inflammatory drugs (NSAIDs)
• steroid injectionsinto affected joints
• disease modifying anti-rheumatic drugs (DMARDs)
• biological therapies.

For the psoriasis:

• 面霜和药膏
• retinoid tablets
• 紫外线疗法，也称为光疗
• 一些用于关节炎的DMARD和生物疗法也可以帮助牛皮癣。

Treatments for the arthritis

非甾体类抗炎药（NSAIDS）

NSAIDs can reduce pain and stiffness, but they might not be enough to treat symptoms of psoriatic arthritis for everyone.

Some people find that NSAIDs work well at first but become less effective after a few weeks. If this happens, it might help to try a different NSAID.

大约有20个可用，包括：

• 布洛芬
• etoricoxib
• 依托拉克
• naproxen.

像所有药物一样，NSAID可以产生副作用。您的医生将通过在最短的时间内开出最低效率的最低剂量来降低这些风险。

NSAIDS有时会引起消化问题，例如胃部不适，消化不良或胃壁损坏。您还应开处方一种称为质子泵抑制剂（PPI）的药物，例如奥美拉唑或兰索拉唑，以帮助保护胃。

对于某些人来说，NSAID可以增加心脏病发作或中风的风险。尽管这种增加的风险很小，但如果还有其他因素可能会增加您的总体风险，例如吸烟，血压，高血压，高胆固醇或糖尿病，您的医生会谨慎开处方NSAID。

Some people have found that taking NSAIDs made their psoriasis worse. Tell your doctor if this happens to you.

Steroid treatment

将类固醇注射到关节中可以减轻疼痛和肿胀，但影响确实消失了。

将过多的类固醇注射到同一关节可能会对周围区域造成一定的损害，因此您的医生会小心不要给您太多。

Steroid tabletsor asteroid injection如果很多关节疼痛和肿胀，则进入肌肉可能会很有用。但是，当这些类型的类固醇治疗衰落时，牛皮癣可能会变得更糟。

如果长期使用，类固醇片可能会引起副作用，例如体重增加和骨质疏松症（OSS-TEE-O-PUR-OH-SIS）。这种疾病可以削弱骨骼并使它们更容易折断。

Disease-modifying anti-rheumatic drugs (DMARDs)

有一些药物可以减慢病情并减少其引起的炎症量。反过来，这可以帮助防止关节损坏。

These are called疾病改良的抗风湿药（DMARDS）(dee-mards). Many DMARDs will treat both psoriasis and psoriatic arthritis.

Because they treat the cause of your condition rather than the symptoms, it can take several weeks or even up to three months before you feel an effect.

即使他们一开始似乎没有工作，您也需要继续服用它们。一旦它们生效，请继续服用它们也很重要。人们通常会服用dmard多年，有时甚至一生。

使用DMARD以及哪个决定取决于几个因素，包括您的症状是什么样的以及联合损害的可能性。

You may need to take more than one DMARD at a time. You can take NSAIDs and painkillers at the same time as DMARDs.

Like all drugs, DMARDs can have some side effects. But it’s important to remember that not treating psoriatic arthritis effectively could lead to permanent bone and joint damage.

When taking a DMARD you’ll need regular blood tests, blood pressure checks, and in some cases a urine test. These tests allow your doctor to monitor the effects of the drug on your condition but also check for possible side effects.

有不同的dmard，它们的工作方式略有不同。尽管也可以注入甲氨蝶呤，但通常将DMARDS视为您吞咽的片剂。它们减少了免疫系统的活性。

诊断后的早期可以使用以下DMARD：

• 甲氨蝶呤
• 磺胺嗪
• leflunomide。

如果其他治疗方法不起作用，您也许可以尝试一些较新的DMARDS。

These newer DMARDs work on specific parts of the immune system to reduce inflammation. They’re taken as tablets you swallow.

以下可以治疗银屑病关节炎：

• 一个premilast
• tofacitinib

两种药物都可以与甲氨蝶呤一起处方。

生物疗法

生物疗法一个re drugs that target key parts of the immune system to reduce inflammation. You might be able to try them if other drugs haven’t worked for you.

Two groups of biological therapies are used to treat psoriatic arthritis – anti-TNF drugs and interleukin inhibitors.

Anti-TNF drugs target a protein called tumour necrosis factor (TNF). Interleukin inhibitors target interleukin proteins.

The body’s immune system produces both TNF and interleukin proteins to act as messenger cells to help create inflammation.

阻止TNF或白介素使者可以减轻炎症并防止对身体损害。

A biological therapy may be prescribed on its own, or at the same time as a DMARD, such as methotrexate.

The following anti-TNF drugs can treat psoriatic arthritis:

• 一个dalimumab
• 英夫利昔单抗
• etanercept
• golimumab
• CERTOLIZUMAB PEGOL。

以下白介素抑制剂可以治疗银屑病关节炎：

• Ustekinumab
• secukinumab
• ixekizumab.

生物疗法最多可能需要三个月才能完全生效。

The psoriatic arthritis treatment pathway

There are now several excellent long-term treatments for psoriatic arthritis. It’s important to find the right one for you as soon as possible, to improve your quality of life and prevent this condition damaging your body.查看我们的银屑病治疗途径图(PDF, 1.2 MB) to find out the order in which these drugs may be taken.

皮肤治疗

如果您的牛皮癣会影响您的生活质量，或者您的治疗无法正常工作，则可能会转介给皮肤科医生。

There are a number of treatment options for psoriasis.

Ointments, creams and gels that can be applied to the skin include:

• 用一种称为二醇的药制成的药膏
• steroid-based creams and lotions
• 维生素D样药膏，例如钙三醇和tacalcitol
• vitamin A-like (retinoid) gels such as tazarotene
• 水杨酸
• 基于焦油的药膏。

For more information about the benefits and disadvantages of any of these talk to your GP, dermatologist or pharmacist.

我f the creams and ointments don’t help, your doctor may suggest light therapy, also known as phototherapy. This involves being exposed to short spells of high-intensity ultraviolet light in hospital.

一旦开始治疗，您就需要定期进行它，并坚持您获得的约会，以使其成功。这种治疗不适用于患有皮肤癌或儿童的高风险的人。对于某些人来说，这种治疗方法会使牛皮癣恶化。

类维生素片，例如腺苷酸，是由与维生素A有关的物质制成的。如果您的牛皮癣不对其他疗法有反应，则可以有用。但是，它们会导致皮肤干燥，如果您患有糖尿病，您可能无法服用它们。

Some DMARDs used for psoriatic arthritis will also help with psoriasis.

People don’t often need joint surgery because of psoriatic arthritis. Very occasionally a damaged tendon may need to be repaired with surgery. And sometimes, after many years of psoriatic arthritis, a joint that has been damaged by inflammation may need joint replacement surgery.

我f your psoriasis is bad around an affected joint when you have surgery, your surgeon may recommend a course of antibiotic tablets to help prevent infection. Sometimes psoriasis can appear along the scar left by an operation, but this can be treated in the usual way.

您可以做一些事情，除了服用处方药，这可能有助于缓解症状。

Staying active

Keeping active is one of the best things you can do to feel better physically and improve your mood.

我t can help reduce pain and stiffness in joints. Being inactive can lead to muscles becoming weak, which can make symptoms worse.

Exercise won’t make your psoriatic arthritis worse. However, if your condition is making certain activities difficult, you might need to change the way you exercise.

我t’s ok to take it easy if your symptoms are bad, and you’ll need to find the right balance between rest and exercise. There are simple exercises you can do when sitting or lying down to keep your joints moving. Every little movement and step really does help in the long-term.

Starting off slowly, and gradually increasing the amount you do can be a good way to start exercising. If you have psoriatic arthritis, you can still be very active – though you may need to build up to this.

游泳可能是锻炼的好方法，因为它不会给关节带来压力。它改善了耐力，力量和灵活性，这是三个重要的健身领域。

有许多好方法锻炼和我的关键s to find something you enjoy as this will help you to keep doing it.

You may find that exercising with your partner, a friend or a relative helps as you can support one another. Group fitness classes can be good fun, if you find the right one for you.

Keeping active is good for your emotional well-being and confidence, as well as making you feel better physically.

如果您正在努力运动，您的医生或physiotherapistcan give you support and advice.

Healthy eating

没有任何饮食可以治愈银屑病关节炎。

饮食健康，平衡，营养丰富且脂肪，盐和糖的饮食对您的整体健康和福祉有益。如果您患有银屑病关节炎，这一点尤其重要。

超重会给您的关节带来额外的压力，例如臀部，膝盖和背部。健康的饮食也对您的心脏健康也有好处。

Eating plenty of fresh fruit and vegetables, and drinking around two litres of water a day is also good for your health. Talk to your doctor, a dietitian or visit theNHS Eatwell Guide website如果您需要更多信息。

得到一些阳光

The right amount of sunshine can make psoriasis better, at least in the short term. Too much sun and sunburn though can make psoriasis worse. For this reason, it’s a good idea to talk to your doctor if you’re planning to go abroad.

戒烟

Smoking can make psoriasis worse. It can also increase the likelihood of some of the potential complications – such as heart problems.

我f you smoke your doctor can give you advice and support to help you stop, or you can visit theNHS Smokefree website。

Complementary treatments

Some people with psoriatic arthritis find complementary treatments are helpful, but you should always talk to your doctor first if you want to try them.

Complementary treatments come from a variety of cultural and historical backgrounds. They’re different to mainstream or conventional medication and therapies that you’ll get from GPs, rheumatology teams or物理治疗师。

Examples of complementary therapies include:

• 针刺– fine needles are inserted at different points around the body to stimulate nerves and produce natural pain-relieving substances in the body known as endorphins.
• The Alexander Technique- 基于通过对身体的良好理解和意识改善姿势和运动的原则。教书的人说它释放了体内的紧张局势。

And there are alternative medicines that can be taken as pills or applied as creams. These can include:

• fish body oil– they contain fatty acids, known as omega-3, that are thought to have health benefits, including reducing inflammation. Though some evidence suggests it’s much better to get these from eating fish like salmon, sardines and mackerel, rather than taking pills.
• 葡萄糖胺– this is an important building block of cartilage, which is the substance that lines the ends of bones in joints to protect them. It’s thought that taking glucosamine sulfate may protect the joints, by slowing down the breakdown of cartilage and replacing lost cartilage.

可能会有一些补充治疗的风险，因此重要的是要去合法注册的治疗师，或者具有设定的道德规范并获得完全保险的人。

我f you decide to try therapies or supplements, you should be critical of what they’re doing for you, basing your decision to continue on whether or not you notice any improvement.

辅助和改编

You may be entitled to free support from your local authority to help make life around the home easier.

You could be offered aids that help with everyday tasks, as well as minor adaptations to your home, to help you get around. This support is available only to people in England who have a physical or mental condition that means they’re unable to do basic tasks and activities, such as:

• cooking
• washing
• going to the toilet
• 穿衣服
• cleaning
• working
• 发展和维护家庭和社会关系。

我f you can’t do two or more of the above, and this has a significant impact on your well-being, you should be eligible.

This would entitle you to aids and minor adaptations up to the value of £1,000 per item. If you need an adaptation that will cost more than £1,000, you can apply for a disabled facilities grant.

有关更多信息，请访问本网站以获取需求评估：www.gov.uk/apply-needs-sassessment-social-Services

工作和银屑病关节炎

牛皮癣关节炎可能使工作生活的某些方面更具挑战性。但是，如果您正在接受正确的治疗，那么当然可以继续工作。

Help and support is available, and you have rights and options.

政府计划访问工作is a grant that can pay for equipment to help you with activities such as answering the phone, going to meetings, and getting to and from work.

《 2010年平等法案》以及《北爱尔兰的《残疾歧视法》法案，雇主都对残疾人的对待比其他任何人都不那么好。银屑病关节炎如果使每天的任务变得困难，则可以将其归类为残疾。

您的雇主可能需要对工作环境进行调整，以便您可以舒适，安全地完成工作。

您也许可以改变工作的某些方面或工作安排，或者培训不同的角色。

为了获得您有权获得的支持，您需要向雇主介绍您的状况。您的经理或人力资源部门可能是一个不错的起点。

Other available support might include:

• your workplace occupational health department, if there is one
• 一个职业治疗师。您可能会被GP转介给一个，或者您可以私下看到一个
• disability employment advisors, or other staff, at your local JobCentre Plus
• 一个Citizens Advice bureau – particularly if you feel you’re not getting the support you’re entitled to.

性，生育和怀孕

有时，对于银屑病关节炎的人，尤其是臀部受到影响的女人，性行为可能会很痛苦。试验不同的位置并与伴侣进行良好的沟通通常会提供解决方案。

银屑病关节炎不会影响您生孩子的机会。但是，如果您想建立一个家庭，重要的是要提前与医生讨论您的药物治疗。如果您意外怀孕，请与您的风湿病部尽早。

The following must be avoided when trying to start a family, during pregnancy and when breastfeeding:

• 甲氨蝶呤
• leflunomide
• retinoid tablets and creams.

越来越多的证据表明，在怀孕期间，其他一些用于银屑病关节炎的药物是安全的。您的风湿病部门将能够告诉您哪些。

我t will help if you try for a baby when your arthritis is under control.

我t’s also important that your arthritis is kept under control as much as possible during pregnancy. A flare-up of your arthritis during pregnancy can be harmful for you and your baby.

牛皮癣和银屑病关节炎可以在家庭中进行。如果您有两种状况，则可以传递可能会增加孩子风险的基因 - 尽管很难预测。随着治疗的不断改善，未来几年的银屑病关节炎患者可以期待更好的前景。如果您有任何疑问或疑虑，请与您的医生交谈。

Having a long-term health condition can affect your mood and confidence, which can have an impact on your work, social life and relationships. Talk things over with your partner, or a friend, relative or doctor if your condition is getting you down. Versus Arthritis has an在线社区这可能会使您与其他银屑病关节炎联系起来。

谈话治疗可能是有用的。例如,cognitive behaviour therapy (CBT) may help you. The aim of CBT is to help people deal with problems in a more positive way, by breaking them down into smaller parts. If you’re interested, your doctor may be able to refer you for CBT, or you could self-refer using theNHS Improving Access to Psychological Therapies (IAPT) service。

Staying physically active will help with pain and stiffness. It will also make you feel better about yourself. Continuing with your normal routine, hobbies and social life as much as possible can be good for your emotional health and well-being.

牛皮癣关节炎可以增加与伴侣和近亲的关系。从最亲近的人那里的支持和理解可能非常重要。

Good two-way communication and understanding can help. Encourage your partner and close relatives to learn about psoriatic arthritis. Let people know if you’re having a bad day. Family therapy sessions might help. The relationship charity Relate could be a good place to turn.

过去的研究和成就

2015年，我们的研究由我们的领导centre for genetics and genomics at the University of Manchesteridentified genetic variants associated with psoriatic arthritis, but not with psoriasis or rheumatoid arthritis. This helped to establish psoriatic arthritis as a condition in its own right. The findings could lead to the development of drugs specifically for psoriatic arthritis.

Later in the same year, our TICOPA trial looked at the benefits of early aggressive drug treatment for people with psoriatic arthritis – followed by an increase in drug dosage if initial treatment isn’t working. The trial found that patients treated this way, required fewer hospital- and community-based services (excluding rheumatology appointments) than patients receiving the standard care.

Ongoing studies

We are currently funding a study at the University of Glasgow that aims to find out whether a molecule called IL-37a can reduce inflammation in inflammatory arthritis, including psoriatic arthritis, and if it could be used to develop new treatments.

We’re funding a study at the University of the West of England looking at how to encourage and help people with psoriatic arthritis become informed about their condition, manage their symptoms, and feel able to make decisions about their treatment. Evidence shows that patients who adopt this proactive approach are more likely to be satisfied with care and have improved symptoms.

A research project at the University of Manchester is looking at whether it’s possible to identify people with psoriasis who are at high risk of developing psoriatic arthritis. This could lead to early intervention with treatment, or ideally preventative treatment.

我们还支持伦敦帝国学院的研究，调查肠道和皮肤上的微生物在银屑病关节炎的患者中是否有所不同。这可以帮助科学家制定简单的诊断测试，这也可以用来预测病情的严重程度。这可能会导致新疗法的发展。

我的银屑病关节炎引起了一些令人难以置信的difficult moments, and I don’t know how I got through them.

But I’m now enjoying life to the full, thanks to anti-TNF medication.

我在捷豹路虎（Jaguar Land Rover）担任经理，而我的工作环游世界。我是12岁的卡里斯（Carys）和安德鲁（Andrew）的妻子的妈妈。

The journey to here has included manysteroid injections分为各种关节，膝盖和许多痛苦的日子。

在23岁那年，我每周要去有氧运动两到三次，我也在上班前游泳。

当我的左膝盖开始肿胀时，由于运动过多，我的全科医生将其放在“膝盖上的液体”上。它变得如此大，我无法走路。在回到贝尔法斯特的旅行中，我的妈妈把我送到了我们的家庭全科医生，后者诊断出我患有银屑病关节炎。

我was devastated and cried all the way home. I assumed my life was over and that I'd be in a wheelchair by 30. I was keen to get back to my exciting life in London, so arheumatologist排干我的膝盖，给了我类固醇注射。

For the next year I regularly had my knee drained and had steroid injections until the rheumatologist said the next step would be keyhole surgery.

在此期间，我独自生活在床上。我有一个转折点。一个晚上，我哭了，以至于第二天无法上班，不是由于我的关节炎，而是由于我见过的最蓬松的眼睛。

我made a decision that day – I would never feel sorry for myself again. I picked myself up, dusted myself off and marched onwards to my dream – happiness.

我moved to the Midlands with work and met Andrew. After we got married, we wanted to have kids. So, I came off my medication, which was very poor advice from my rheumatologist at the time, as my condition spiralled. And my husband saw my arthritis in all its glory. I went from being independent and strong, to a woman who he had to help dress.

我spent my maternity leave in constant pain. The worst part was going to Rhythm Time classes and being the only mum who couldn't sit on the floor with her baby, I was on the only chair in the circle. It was hard but seeing Carys's smiling face looking up at me made my heart leap for joy.

我可以肯定地说，我找到了我的幸福。不仅在我的婚姻生活中，而且在我的工作中，以及与我的朋友和更广泛的家庭圈子。我想成为我能成为的最好的人，我希望自己的生活成为最好的人。银屑病关节炎不会阻止这一点。