Psoriatic arthritis is a specific condition in which a person with psoriasis develops arthritis. In psoriasis the skin is affected and joints can often get affected by psoriasis.
The exact cause of psoriatic arthritis is not understood. Several factors which perhaps promote the development of psoriatic arthritis include genetic (family), environmental, and immune causes.
Psoriatic arthritis has a variable presentation. It can affect joints in a symmetrical or asymmetrical pattern, and any joint of the body (like small joints of the hand, knee, hip) can be affected. It usually affects multiple joints. Psoriasis can affect the nails. In these patients the joints nearest the fingertips are likely to become arthritic.
Common symptoms associated with psoriatic arthritis besides joint pain includes:
- swollen fingers and toes
- morning stiffness of joints
- low back pain
Tests and Diagnosis
Early and accurate diagnosis is essential so proper treatment can be started. Specific clinical, laboratory or radiographic criteria for the diagnosis of psoriatic arthritis are not available. Physical examination, blood tests, x-rays, CT scan and MRI may be done to rule out other types of arthritis (such as rheumatoid arthritis, gout, reactive arthritis) with similar symptoms.
- Blood tests for rheumatoid factor, anemia, inflammatory markers
- X-ray: Findings if an X-ray can help your doctor distinguish psoriatic arthritis from other types of arthritis.
- CT scan: CT scan of the pelvis and hip may be done if you have spine, pelvis, or hip symptoms.
- MRI may be done to assess joint involvement, especially of the hands and feet if the diagnosis is not clear.
The aim of treatment for psoriatic arthritis is to control inflammation and pain. Treatment for psoriatic arthritis helps to ease pain, reduce swelling, helps to keep joints working properly and possibly prevent further joint damage. Doctors will recommend treatment for you based on the type and severity of psoriatic arthritis and your reaction to treatment.
Early diagnosis and treatment can slow the progression of disease, preserve function of the joint and range of motion.
Medications: Medications used to control pain and inflammation in psoriatic arthritis include nonsteroidal anti-inflammatory drug (NSAID), DMARDs, and biologics.
- NSAIDs such as ibuprofen, diclofenac, aspirin, naproxen can help to relieve morning stiffness and pain.
- COX-2 inhibitors like celecoxib can help to relieve morning stiffness and pain.
- Disease-modifying antirheumatic drugs (DMARDs) are given to control more severe symptoms and in an attempt to slow or stop joint and tissue damage in psoriatic arthritis.
- If the pain and inflammation are severe your doctor may inject your joint with a steroid to relieve inflammation and pain.
Other therapies: Rest, heat and physical therapy are important adjuncts in the treatment of pain in psoriatic arthritis along with drug therapy.
- In acute inflammation and pain rest for 2 to 3 days can help to ease pain. Start exercise of the affected joint slowly, as this can help recovery.
- Pain may be relieved with a local application of moist heat.
Surgery: If the joint is severely deformed and the pain is not controlled by medications surgery and rehabilitatio...
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