Psoriatic arthritis is an inflammatory joint disease that can affect those with psoriasis. Learn more about psoriatic arthritis tests and diagnosis. Psoriatic arthritis (PsA) is a type of inflammatory arthritis that affects the joints and entheses (the connective tissue between bone and tendons or ligaments). Common symptoms of PsA are joint pain, swelling, and morning stiffness. According to
Psoriatic arthritis (PsA) is a type of inflammatory arthritis that affects the joints and entheses (the connective tissue between bone and tendons or ligaments). Common symptoms of PsA are joint pain, swelling, and morning stiffness. According to the National Psoriasis Foundation (NPF), PsA affects up to 30% of people with the autoimmune skin condition psoriasis.
Both PsA and psoriasis are autoimmune diseases, conditions where the immune system malfunctions and attacks healthy tissues. With PsA, those attacks are on the joints and entheses, leading to severe inflammation and swelling. With psoriasis, those attacks are on the skin, causing the body to make new skin cells more often, which pile up on the skin’s surface.
This article covers the symptoms of PsA, tests for diagnosing the condition, and when to see a healthcare provider.
PsA can affect any joint in the body. It can be asymmetrical (affecting joints on one side of the body) or symmetrical (involving the same joints on both sides).
Symptoms of PsA can start gradually and slowly worsen. They can also come on suddenly and become painful and severe quickly.
Symptoms of PsA include:
PsA can lead to other severe health conditions. These conditions are caused by the same inflammatory processes that attack the joints and skin. PsA treatment can prevent these complications.
PsA disease complications might include:
There is no single test that can confirm a diagnosis of PsA. Your healthcare provider will rely on blood work, imaging, bone density scans, joint fluid testing, and more in determining the source of your symptoms.
Blood tests can help confirm PsA and rule out other types of inflammatory arthritis.
If your healthcare provider suspects PsA, they will request imaging studies, including X-rays, magnetic resonance imaging (MRI), and ultrasound.
According to a 2018 report in the journal Arthritis & Therapy, PsA imaging is vital even early in the disease process. PsA can cause bone erosion (loss of normal bone) and joint destruction even before you notice symptoms. These changes are specific to PsA and rarely seen with other types of inflammatory arthritis.
The different types of imaging that look for signs of PsA are:
Arthrocentesis, or a joint fluid test, takes a small amount of fluid from the knee or another joint. If uric acid crystals are found in the fluid, your healthcare provider might look into further testing for gout.
People with inflammatory diseases like PsA can develop anemia (low number of healthy red blood cells). Symptoms of anemia include exhaustion, dizziness, and shortness of breath.
Chronic inflammation is generally the cause of anemia in PsA. This type of anemia is treated by getting inflammation under control. Tests for anemia include a complete blood count and may include tests for iron levels to rule out other types of anemia.
Additional diagnostic tools that aid your healthcare provider in a PsA diagnosis are your medical and family history and a physical examination.
Your healthcare provider will ask when your symptoms started and the specific symptoms you have experienced. They will also want to know if you have a personal medical history of psoriasis or a family history of PsA or psoriasis.
If you are experiencing more severe symptoms of PsA, including eye problems and gastrointestinal symptoms, you should let your healthcare provider know. These symptoms might be an indication that PsA is quickly progressing.
Your healthcare provider will want to examine the joints, entheses, skin, and nails if they suspect PsA.
PsA is a progressive condition that will worsen over time and lead to severe, life-threatening complications if left untreated. It is, therefore, crucial to get a timely diagnosis and start treatment before joint and bone damage starts.
A timely diagnosis is critical if you have psoriasis or a family history of PsA or psoriasis. But you can still get PsA without risk factors.
Regardless of risk factors, reach out to your healthcare provider if you experience any of the following:
The sooner you receive a PsA diagnosis and start treating, the better your chance of avoiding joint and bone damage.
Psoriatic arthritis is an autoimmune disease where the immune system malfunctions and attacks healthy tissues, mainly the joints and entheses. Common signs of the condition are joint pain, morning stiffness, swollen fingers and toes, skin rash, and pitted nails.
No one test can confirm PsA, so healthcare providers must rule out other conditions that cause similar symptoms, including rheumatoid arthritis and gout. A diagnosis may require a medical and family history, physical examination, blood work, lab testing, and imaging.
Psoriatic arthritis is a lifelong condition without a cure. But the outlook for the condition is improving and will continue to improve as researchers look for new and more advanced treatment options. The many currently available treatment options can relieve your symptoms, slow down disease progression, and even lead to remission.
It is OK to be hopeful about the future with a chronic condition like PsA. Choose to keep doing the things that make you happy and stay connected with friends and family as much as you can. If you think you are depressed or just struggling to cope, find a therapist you can trust.
Blood tests alone cannot confirm psoriatic arthritis. Instead, a healthcare provider will rely on diagnostic methods that include a medical history, physical examination, blood, and other lab work, and imaging studies.
One of the earliest signs of psoriatic arthritis is morning stiffness or stiffness that occurs after inactivity for long periods. PsA may also cause pain and stiffness in one or more joints, usually the fingers and toes, but a large joint can also be affected. PsA can also cause soreness and tenderness of the entheses.
Psoriatic arthritis is a lifelong condition with no cure. However, it is manageable and treatment. And PsA treatment has come a long way in the last two decades leading to increased opportunities for remission—periods of low disease activity or no symptoms.