How to test for psoriatic arthritis?
What is psoriatic arthritis?
Psoriatic arthritis is an inflammatory disease with genetic and immunological characteristics, which affects ligaments, tendons, small and large joints (joints) and in addition to pain, can cause progressive destruction of joints. Men and women can be affected in the same proportion.
Psoriatic arthritis is directly linked to psoriasis disease in which the immune system causes an inflammation in the skin leaving on it red and white, scaly plaques. One in three patients with psoriasis may have swelling, pain in the joints of the extremities and back pain which we call articular manifestations of psoriatic arthritis or simply psoriatic arthritis.
Most often psoriasis comes before realizing the articular manifestations, regardless of the severity of the skin disease. However, sometimes the articular manifestations can appear before psoriasis. In a few cases psoriasis and articular manifestations occur simultaneously.
There are five different clinical forms of psoriatic arthritis, can be anything from involvement of a few joints to many joints, as well as severe forms with destruction of joints. It can also affect other regions. The same patient may present more of a clinical type of psoriatic arthritis depending on the progress of the disease and the period in which she/he was diagnosed.
- Oligoarticular JIA, that amounts to less than five pairs and occurs in large joints, such as knees and ankles, but it may also involve joints of the hands and feet.
- Polyarticular, which is more than five joints and resembles rheumatoid arthritis. It can cause deformities and involves the hands, feet, knees and ankles.
- Involvement of the distal joints of the fingers, that occurs mainly in portion(s) that are closer to the nails.
- Mutilating form: that proves destruction in the joints, especially the hands and feet.
- Preferential involvement of the spine : a rarer form, which also causes pain in the spine, causing physical limitations.
Psoriatic arthritis occurs when the immune system attacks healthy cells and tissues of the body, causing inflammation on the skin and joints (joints). There is still no agreement on the causes that promote this behavior in the body, but the genetic factors appear to be the most relevant. An example of this is that many of the patients with psoriatic arthritis have a family history of psoriasis or psoriatic arthritis. .
Genetics has clear role in the development of psoriatic arthritis. Approximately 40% of patients with psoriasis or psoriatic arthritis have a family history of the disease in first degree relatives.
Environmental and behavioral factors (obesity, smoking, consumption of alcohol and infections) have been reported as risk factors for onset or worsening of the disease.
Psoriatic Arthritis Symptoms
Prepare for consultation
Check your symptoms and take your list to the doctor.
Often the patient has the following symptoms:
- Psoriasis skin (inflammation of the reddish skin and leaving her with brancoescamosas plates), with format similar to sausages.
- Nail changes.
- Swelling of one or more fingers and / or toes, resembling sausages.
- Pain, redness, warmth.
- Back pain.
- Difficulty moving the joint(s) in the morning.
- Pain in the muscles and tendons.
Symptoms related to changes in the skin are the most representative.
Like psoriasis, psoriatic arthritis tends to get worse with time, so it is important to diagnose and treat early.
Psoriatic arthritis Diagnosis
The diagnosis of psoriatic arthritis is basically made from the symptoms and clinical examination by a rheumatologist. But note, not all joint inflammation in patients with psoriasis is necessarily psoriatic arthritis. The doctor will test the joints and check the patient’s skin condition to understand the problem.
There is a test to confirm whether or not psoriatic arthritis, but some examinations can be made to aid in the diagnosis and rule out other diseases such as: blood test, X-ray and MRI.
Psoriatic arthritis Treatment
Treatment of psoriatic arthritis varies depending on the form of presentation of the disease. Remember that the diagnosis and treatment should always be made and monitored by a doctor. Often patients are treated with drug therapy and if necessary and in a few cases surgery.
Anti-inflammatory drugs are usually used to alleviate or treat inflammation and reduce the pain of the joints and spine.
In some cases, treatment of psoriatic arthritis is done with medications called rheumatic disease modifying drugs which can be separated into two different groups: synthetic and biological.
Physical therapy is a part of the treatment that seems to be beneficial to minimize pain, stiffness and prevent disease progression.
Only in a few cases (very advanced stage of the disease) you may need a surgical procedure to correct any joint that can bring back the function and ease the pain.