Psoriatic arthritis


Psoriatic arthritis (PsA)

Description, Causes and Risk Factors:

The concurrence of psoriasis and polyarthritis, resembling rheumatoid arthritis but thought to be a specific disease entity, seronegative for rheumatoid factor and often involving the digits.

Psoriatic arthritis is a type of arthritic inflammation that occurs in about 15% of patients who have a skin rash called Psoriasis. This particular arthritis can affect any joint in the body, and symptoms vary from person-to-person.

Psoriasis is a disease in which scaly red and white patches develop on the skin. Psoriasis is caused by the body's Immune system going into overdrive to attack the skin. Some people with psoriasis can also develop Psoriatic arthritis, when the immune system attacks the joints as well as causing inflammation. The exact etiology of Psoriatic arthritis is not known, but genetics plays a big role. If someone in your family has psoriasis or psoriatic arthritis, there is a greater chance that you will develop it.

Doctors have discovered five general patterns of Psoriatic arthritis. In the asymmetric pattern, one of the mildest forms, the psoriatic arthritis affects one to three joints on different sides of the body. In the symmetric pattern, PsA involves many more joints and looks very much like Rheumatoid arthritis. In the distal pattern, PsA involves the end joints of the fingers closest to the nails. In the spinal pattern, PsA involves the joints of the spine and the sacroiliac joints linking the spine to the pelvis. Finally, in the destructive pattern, which affects only a few people, PsA is a severe, painful, deforming type of arthritis. This is also known as arthritis mutilans.

Psoriatic arthritis can affect any joint in the body, and it may affect just one joint, several joints, or multiple joints. Psoriatic arthritis also can cause tender spots where tendons and ligaments join onto bones. Psoriatic arthritis usually appears in people between the ages of 30 to 50, but can begin as early as childhood. Men and woman are equally at risk. Children with Psoriatic arthritis are also at risk to develop uveitis.

Symptoms:

    You start to feel unusual pain and stiffness in a joint or joints.

  • This pain and stiffness is worse in the morning, typically lasting more than 30-60 minutes before the joints "loosen up" and start feeling better.However, the pain and stiffness can be with you (to some degree) most of the day, even causing discomfort while you try to sleep at night.

  • Some people notice that they feel more tired when PsA starts and some people gain a little weight because they haven't been as active.

  • Fatigue and anemia are common.

  • Some psoriatic arthritis patients also experience mood changes.

Diagnosis:

To diagnose Psoriatic arthritis, Rheumatologist looks for swollen and pain joints, certain patterns of arthritis, and skin & nail changes typical for Psoriasis. X-rays often are taken to look for joint damage. MRI and ultrasound or CT scans can be used to look at the joints in more details.

Blood test may be done to rule out other type of arthritis that have similar Signs & symptoms including Gout, osteoarthritis, rheumatoid arthritis. In patients with psoriatic arthritis, blood tests may reveal high levels of inflammation and mild anemia. Occasionally skin biopsies are needed to confirm the psoriasis.

Treatment:

Treatment varies depending on the level of pain. Those with very mild arthritis may require treatment only when their joints are painful and may stop therapy when they feel better. If the arthritis does not respond, disease-modifying antirheumatic drugs (DMARDs) may be prescribed. For swollen joints, corticosteroids injections can be useful. Surgery can be helpful to repair or replace badly damaged joints.

Non-medication therapies, such as Physiotherapy, occupational therapy, education, physical activity and relaxation techniques, are a very important part of the treatment of Psoriatic arthritis. While you can perform them on your own, it's best that you first ask a health-care professional, such as a Physiotherapist or occupational therapist, for guidance.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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