Psoriatic Arthritis (PsA)
Psoriasis is a serious chronic autoimmune disease that affects the skin and the joints. Eight million Americans suffer with psoriasis. Almost 30% of these Americans develop psoriatic arthritis. However, you don’t need to have psoriasis to develop psoriatic arthritis.
What is psoriatic arthritis?
Psoriatic arthritis is a chronic, inflammatory form of arthritis that causes swollen, stiff and painful joints and attacks ligaments and tendons, causes nail changes and severe fatigue. It usually develops in people aged 30-50 but can also affect children ages 10-12.
A majority of patients develop psoriasis first; but PsA can develop at the same time as psoriasis; and 10-15% develop arthritis before psoriasis. Early diagnosis and treatment can limit joint damage and improve symptoms. Studies report that delaying treatment for psoriatic arthritis by even six months can cause permanent joint damage.
What causes PsA?
Like psoriasis, PsA is an autoimmune disease. About 40% of people with PsA have at least one relative with the disease. The immune system, genetics and environmental factors all play a role in causing PsA.
What are the symptoms of PsA?
- Warm red and swollen joints
- Stiff, tender and painful joints and tendons
- Painful feet and ankles
- Sausage-like fingers and toes
- Morning stiffness and fatigue
- Low back pain
- Limited range of motion
- Nail changes including pitted nails and nails that separate from the nail bed. Nail lesions affect 80-90% of PsA patients.
- Painful, red eyes
PsA may begin with mild symptoms or develop quickly. Every case is different. Your PsA may be mild or severe depending on the number of joints affected. Mild PsA typically affects four or fewer joints, while severe PsA affects four or more joints.
How is PsA diagnosed?
The signs and symptoms of PsA are similar to those of rheumatoid arthritis, gout and reactive arthritis that is caused by an infection in another part of the body.
There is no conclusive test, rather your condition will be diagnosed based on your Ortho Illinois rheumatologist’s examination, medical history, family history, your signs and symptoms; and blood tests, x-rays and other imaging tests.
Your rheumatologist will rule out rheumatoid arthritis with a blood test; and RA typically affects the same joints on both sides of the body, while PsA does not.
They will also rule out gout, which is due to high levels of uric acid, but people with PsA can also have elevated levels of uric acid. A recent study found that people with PsA have an increased risk of gout that usually appears just before the diagnosis of psoriasis or psoriatic arthritis.
Also, PsA typically attacks the spine causing a stiff neck, low back pain and sacroiliac joint pain. This is called Spondylitis.
What are distinguishing indictors of PsA?
Enthesitis: When the PsA attacks the ligaments and tendons it is called Enthesitis and commonly affects the bottom of the feet, the Achilles’ tendon and other ligaments in the spine, pelvis and ribs. This symptom is unique to PsA and doesn’t occur in other types of arthritis.
Dactilitis or Sausage Digits: Inflamed and swollen fingers or toes are due to inflamed tendons. This is unique to PsA.
Your rheumatologist will make a diagnosis and develop a treatment plan based on all the information that they have gathered.
What are the treatments for PsA?
Your treatment plan will be based upon the most current clinical practice guidelines. Over the counter anti-inflammatory medications, weight loss, physical therapy, occupational therapy, smoking cessation, massage therapy and exercise are first line treatments. Oral medications and biologic drugs that target the immune system can fight the symptoms and slow joint damage.
Contact Ortho Illinois to schedule a consultation with one of our team of rheumatologists located in Rockford for your convenience. Contact us to schedule a consultation and receive the correct diagnosis and treatment from our renowned physicians.