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Why Diagnosing Psoriatic Arthritis Can Be Tricky

Spotting the disease usually involves a combination of tests.

By John Riddle

Medically Reviewed by Sanjai Sinha, MD

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A physical exam and a review of your medical history are key diagnostic tools to spot psoriatic arthritis.
A physical exam and a review of your medical history are key diagnostic tools to spot psoriatic arthritis.
David P. Hall/Getty Images

There’s no single test for psoriatic arthritis, an autoimmune disorder, and its symptoms can resemble signs of other conditions.

“The diagnosis of psoriatic arthritis is not always the easiest one to make,” says Nathan Wei, MD, the director of the Arthritis Treatment Center in Frederick, Maryland. “Roughly 30 percent of patients with psoriasis will eventually develop psoriatic arthritis. Not everyone with psoriasis gets psoriatic arthritis.”

Still, “it is important that patients who have psoriasis see a rheumatologist for evaluation,” says Charles E. Crutchfield III, MD, a clinical professor of dermatology at the University of Minnesota Medical School in Minneapolis.

Looking for Signs

To diagnose psoriatic arthritis, a doctor will look for swollen and painful joints. The condition can cause pain in the neck or lower back as well as the fingers and feet. “It can also cause swelling in areas where tendons and ligaments attach to bones, known as enthesitis; or swelling of an entire finger or toe, known as dactylitis,” Dr. Wei says.

While a dermatologist can treat psoriasis, a rheumatologist is the most appropriate physician to diagnose psoriatic arthritis.

“In the past, we thought [the inflammation from psoriasis] affected only our skin, but now we know that the inflammation affects our skin, joints, and blood vessels,” says Dr. Crutchfield. “As a result, patients with psoriasis are at increased risk for developing skin rashes, arthritis, heart disease, diabetes, high blood pressure, and gum disease.”

According to the Arthritis Foundation, there are five types of psoriatic arthritis, and about half of all people diagnosed with the condition have a type called symmetric psoriatic arthritis. Similar to rheumatoid arthritis, symmetric psoriatic arthritis affects joints on both sides of the body at the same time.

Ruling Out Other Conditions

Psoriatic arthritis is sometimes misdiagnosed as rheumatoid arthritis, osteoarthritis, or gout. Since gout is caused by too much uric acid in the body, your doctor may take fluid from the joint space to see if it contains uric acid crystals to rule out that condition.

A psoriatic arthritis diagnosis usually requires a combination of imaging tests (X-rays and magnetic resonance imaging, or MRI) to spot issues with joints, tendons, and ligaments, as well as blood tests to rule out other conditions like rheumatoid arthritis.

A thorough physical exam and a review of your medical history are also key diagnostic tools.

The good news is that psoriatic arthritis, though not curable, is very treatable. “Once it's diagnosed, most cases can be put into remission,” Wei says.






Video: 8 Early Signs Of Arthritis | Arthritis Symptoms

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Date: 17.12.2018, 06:28 / Views: 91231


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