Psoriatic arthritis (PsA) is a chronic inflammatory joint disease associated with the skin condition psoriasis. Psoriatic arthritis can affect multiple body tissues, including the joints, skin, and nails. Show
In PsA, an overactive immune system mistakenly attacks healthy body tissues, resulting in pain and inflammation. It is unclear why some people with psoriasis develop PsA while others do not. This article describes PsA, including the different types. We also provide information on diagnosing and treating PsA and offer advice on when to consult a doctor. Finally, we cover the outlook for people living with PsA and compare the differences between PsA and rheumatoid arthritis. PsA is a form of chronic inflammatory arthritis that affects around 15% of people with the skin condition psoriasis. Medical experts do not yet understand why some people with psoriasis go on to develop PsA while others do not. PsA can cause pain and inflammation in multiple body tissues, including:
Psoriasis and PsA are autoimmune conditions in which the immune system mistakenly attacks healthy body cells and tissues. Experts do not fully understand what causes these conditions. However, around 40% of people with PsA have a family member with psoriasis or PsA, suggesting a genetic link. There is no definitive test for PsA. To diagnose the condition, a doctor will:
If preliminary investigations suggest that a person may have PsA, the doctor may make a referral to a rheumatologist. This is a doctor who specializes in disorders of the musculoskeletal system. The rheumatologist will aim to rule out other forms of arthritis, such as rheumatoid arthritis (RA), osteoarthritis, and gout. They may order the following tests to assist with the diagnosis:
There are five main types of PsA. These types differ according to the area of the body the condition affects, as well as the number of joints involved. The five types of PsA are:
Diagnosis of PsA can follow the CASPAR criteria, which stands for classification for psoriatic arthritis. The criteria state that to receive a diagnosis of PsA, a person must first have received a diagnosis of inflammatory articular disease. Such diseases typically cause symptoms such as joint pain, swelling, and stiffness. For a diagnosis of PsA using the CASPAR criteria, a person must also score at least three points from the options listed below:
A person should consult a doctor if they have a personal or family history of psoriasis and begin to experience symptoms of PsA, such as persistent joint pain, swelling, or stiffness. A doctor will run tests to determine whether the person has PsA. A person should also talk with a doctor if they have already received a diagnosis of PsA and experiencing a particularly severe or persistent flare of the condition. Symptoms may include:
There are many treatment options for PsA. These treatments aim to:
In 2018, the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF) provided an evidence-based guideline for the treatment of PsA. Below are some of the treatments featured in these guidelines. Nonmedical treatmentsNonmedical treatment options that may help to alleviate the symptoms of PsA include:
Medical treatmentsThe 2018 guidelines also list a range of medical treatments that may help alleviate the symptoms of PsA or help slow the progression of the disease. Examples are as follows. Nonsteroidal anti-inflammatory drugs (NSAIDs)NSAIDs block the production of prostaglandins that signal the body’s immune system to trigger an inflammatory response. Common over-the-counter NSAIDs are ibuprofen and naproxen. GlucocorticoidsGlucocorticoids are steroid hormones that can help suppress the immune system and reduce inflammation and associated tissue damage. According to the Psoriasis and Psoriatic Arthritis Alliance (PAPAA), a person may take low dose steroid tablets to help alleviate PsA pain and stiffness. Doctors may also prescribe a temporary high dose to help a person recover from a PsA flare. In some cases, a person may receive an injection of steroids into the affected joints to reduce localized pain and inflammation. Disease-modifying antirheumatic drugs (DMARDs)DMARDs are medications that slow the biological processes responsible for causing chronic inflammation. In this way, DMARDs help slow the progression of PsA. Examples include:
Psoriatic arthritis is a chronic condition that can worsen over time. Without treatment, severe cases may result in permanent joint damage and deformity. Such cases may require surgical treatment. However, diagnosing and treating PsA in its earlier stages can help slow the progression of the disease and reduce the risk of permanent joint damage. PsA and RA are both inflammatory forms of arthritis that occur due to the immune system attacking healthy body cells and tissues. The key difference between the two conditions is that PsA involves the skin as well as the joints. Other differences include:
PsA is a chronic inflammatory skin condition associated with the skin disease psoriasis. Both conditions occur due to the immune system mistakenly attacking healthy body cells and tissues. A person should consult a doctor if they experience symptoms of PsA, especially if they have an existing diagnosis of psoriasis. Symptoms include joint pain, swelling, stiffness, and general fatigue. Early diagnosis and treatment of PsA can improve the outcome for people living with the disease. The diagnostic procedure for PsA typically involves a combination of imaging tests and blood tests. Treatment options are varied and include NSAIDs, glucocorticoids, and DMARDs. Can a blood test show psoriatic arthritis?HLA-B27 is a blood test that looks for a genetic marker for psoriatic arthritis — a protein called human leukocyte antigen B27 (HLA-B27), which is located on the surface of white blood cells. About 20 percent of people with psoriatic arthritis are positive for HBL-B27, according to CreakyJoints.
How do u know if u have psoriatic arthritis?Joint pain, stiffness and swelling are the main signs and symptoms of psoriatic arthritis. They can affect any part of the body, including your fingertips and spine, and can range from relatively mild to severe. In both psoriasis and psoriatic arthritis, disease flares can alternate with periods of remission.
Is psoriatic arthritis hard to diagnose?Psoriatic arthritis (PsA) is a chronic inflammatory spondyloarthritis that occurs in combination with psoriasis. The prevalence is similar to rheumatoid arthritis. The diagnosis is difficult because the disease is heterogeneous, involving skin, nails and different musculoskeletal structures.
What tests are positive with psoriatic arthritis?The most characteristic laboratory abnormalities in patients with psoriatic arthritis are elevations of the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level. The results from these laboratory tests help to track the activity of the disease by measuring inflammation.
Does psoriatic arthritis show up on xray?In the early stages, changes may not be visible on an X-ray. As PsA advances, however, an X-ray will show the bones that experience damage and shape changes. As PsA progresses, bone changes may be visible by looking, for example, at the hands or feet.
How do you rule out psoriatic arthritis?Psoriatic Arthritis Diagnosis. An examination by the physician determining if the joints are swollen or tender. ... . Blood tests to rule out rheumatoid arthritis called a rheumatoid factor and an Anti-cyclic citrullinated peptide antibody test. ... . Sometimes an X-ray or radiograph of the hands or feet to look for any damage done.. |