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How Do You Get a Psoriatic Arthritis Diagnosis?

Psoriatic arthritis is an inflammatory type of arthritis that sometimes occurs in people with the chronic skin condition psoriasis. Psoriatic arthritis is diagnosed with a visit to the doctor's office, which will include taking patient history, a physical exam, lab tests, and imaging tests.
Psoriatic arthritis is an inflammatory type of arthritis that sometimes occurs in people with the chronic skin condition psoriasis. Psoriatic arthritis is diagnosed with a visit to the doctor's office, which will include taking patient history, a physical exam, lab tests, and imaging tests.

Psoriatic arthritis is an inflammatory type of arthritis that may develop in patients who have psoriasis, a chronic autoimmune skin condition that causes rapid skin cell growth and renewal. 

Psoriatic arthritis is diagnosed with a patient history and physical examination to check for swollen and tender joints, as well as a skin examination to check for signs of psoriasis, along with tests to help diagnose psoriatic arthritis or to rule out other conditions that have similar symptoms to psoriatic arthritis. Tests used to help make a diagnosis include: 

What Are Symptoms of Psoriatic Arthritis?

Symptoms of psoriatic arthritis include:

  • Joint pain, swelling, and stiffness
    • Often on one side of the body
    • Pain is worse in the morning or after resting
    • Can affect any joint, but commonly occurs in large joints of lower extremities such as the knees and ankles 
  • Pain and stiffness of the neck and lower back
  • Back, hip, and shoulder pain
  • Reduced range of motion in the joints
  • Heel pain and foot pain 
  • Skin symptoms 
    • Skin rash (psoriasis)
    • Red patches of skin with silvery scales (plaques)
      • Commonly appears on the scalp, elbows, knees, and around the ears
    • Skin redness and warmth 
    • Scaly and itchy skin
    • Thickening skin
  • Fatigue
  • Sausage-like swelling of fingers and/or toes
  • Nails separate from nail bed
  • Pitted, crumbling nails
  • Eye inflammation such as pink eye (conjunctivitis)

How Is Psoriatic Arthritis Treated?

There is no cure for psoriatic arthritis. Treatment for psoriatic arthritis depends on the patients’ symptoms and severity, and the goal is to relieve symptoms and prevent further joint damage. 

Nonsteroidal anti-inflammatory drugs (NSAIDs) to treat pain and inflammation may be used such as:

  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve)
  • Aspirin
  • Celecoxib (Celebrex) 

Treatment for more severe cases of psoriatic arthritis may include: 

  • Corticosteroid injections into the joints
  • Disease-modifying antirheumatic drugs (DMARDs) 
    • Nonbiologics 
      • Apremilast (Otezla) 
      • Azathioprine (Azasan)
      • Hydroxychloroquine (Plaquenil)
      • Leflunomide (Arava)
      • Methotrexate (Folex, Rheumatrex, Rasuvo, Otrexup, Xatmep, Trexall)
      • Sulfasalazine (Azulfidine EN-tabs, Azulfidine, Sulfazine)
    • Biologics (antitumor necrosis factor (TNF) agents)
      • Abatacept (Orencia) 
      • Adalimumab (Humira)
      • Etanercept (Enbrel)
      • Golimumab (Simponi)
      • Infliximab (Remicade)
      • Ixekizumab (Taltz)
      • Secukinumab (Cosentyx) 
      • Tofacitinib (Xeljanz) 
      • Ustekinumab (Stelara) 
  • Topical treatments for psoriasis symptoms
    • Over-the-counter or prescription salicylic acid creams, gels, and shampoos
    • Retinoid and steroid creams
    • Prescription vitamin D creams
  • Immunosuppressants 
    • Cyclosporine (for severe cases that do not respond to other systemic treatments)

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References
https://www.psoriasis.org/

https://www.niams.nih.gov/Health_Info/Psoriatic_Arthritis/default.asp

https://www.uptodate.com/contents/psoriatic-arthritis-beyond-the-basics

https://creakyjoints.org/

https://www.arthritis.org/

https://www.ncbi.nlm.nih.gov/books/NBK115127/