Psoriatic Arthritis – Diagnosis and Treatment
Diagnosis
Scans and Imaging
Doctors use several types of imaging to learn more about the joints and surrounding tissues. X-rays reveal changes linked with psoriatic arthritis that are not typical in other forms of the disease.
| Imaging Technique | What It Detects | Common Uses |
|---|---|---|
| X-ray | Joint and bone changes | Joint pain, swelling |
| MRI | Soft tissue and bone details | Tendon and ligament issues |
These images help spot issues such as joint damage or changes in bone. MRI scans give a clear picture of both bone and soft tissue.
MRI scans help doctors detect problems like inflammation of tendons and ligaments, especially in the feet or back.
Blood Work and Joint Fluid Tests
Doctors often order a few blood tests. One test looks for rheumatoid factor (RF), which usually does not appear in people with psoriatic arthritis.
If doctors find RF, it may point to another type of arthritis, such as rheumatoid arthritis. They may also order a joint fluid analysis.
Doctors use a needle to take fluid from an affected joint to check for uric acid crystals. Finding these crystals can mean gout instead of psoriatic arthritis.
- Blood tests help rule out other types of arthritis.
- A negative rheumatoid factor test supports psoriatic arthritis over rheumatoid arthritis.
Additional Facts and Considerations
Doctors rely on a detailed physical exam to check for joint swelling, tenderness, and nail changes. Family history, the presence of psoriasis, and the pattern of joint pain or stiffness are also important.
Signs like dactylitis (swollen fingers or toes) and enthesitis (tenderness where ligaments attach to bone) support the diagnosis. A mix of symptoms and test results guides doctors in making a clear diagnosis.
Treatment
Medicines for Psoriatic Arthritis
People with psoriatic arthritis use different medicines based on their symptoms and what their doctor recommends. Common options include:
| Type of drug | Purpose | Possible side effects |
|---|---|---|
| Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) | Lessen pain and swelling | Stomach upset, heart risks, kidney/liver problems |
| Traditional Disease-Modifying Antirheumatic Drugs (DMARDs) | Slow joint damage, control swelling | Liver issues, reduced blood counts, lung problems |
| Biologic Drugs | Target the immune system to lower inflammation | Higher risk of infections |
| Targeted Synthetic DMARDs | For cases not helped by other medicines | Blood clots, heart risks, cancer with higher doses |
| Other Medicines | Lower inflammation, especially for those who can’t take other drugs | Stomach upset, headaches |
Doctors usually try one medicine first and may switch if it does not work or causes side effects. People should talk with their health care provider about the benefits and risks before starting any new medicine.
Supportive Treatments and Therapies
Other types of care can help make life easier with psoriatic arthritis:
- Physical therapy: Exercises improve movement and make muscles stronger. These can help lessen joint stiffness.
- Occupational therapy: Therapists show ways to do daily tasks more easily and protect sore joints.
- Massage therapy: Massage may give some pain relief and reduce tension.
- Splints or braces: Wearing these can support swollen or painful joints and help keep them from getting worse.
Therapists help people find the best tools and exercises for their needs.
Surgical Options and Special Procedures
If joints become badly damaged, some people need more than medicine and therapy:
- Steroid Shots: Doctors put corticosteroids right into painful joints. These shots cut down swelling and give short-term relief.
- Joint Replacement: If a joint is very damaged, surgeons remove it and put in an artificial joint made from metal or plastic. This is most common for hips and knees.
Doctors usually recommend these steps for those who do not get better with other treatments.
Ways to Take Care of Yourself
Taking care of yourself can help manage psoriatic arthritis symptoms. Small changes in daily habits and choices may help reduce pain and improve how the joints feel.
Using tools like jar openers, lifting with both hands, and pushing heavy doors with the body instead of just the hands can protect vulnerable joints.
Maintaining a healthy weight is important because extra weight puts more stress on the joints. Even a small amount of weight loss can help decrease pain and increase movement.
Exercise helps keep joints flexible and muscles strong. Gentle activities like swimming, walking, biking, yoga, and tai chi are less likely to strain the joints.
Consistency matters more than intensity. It is a good idea to take breaks when tired, instead of pushing too hard or doing everything at once.
People should avoid smoking and limit alcohol. Smoking can make the disease worse, while alcohol can reduce how well some medicines work and may cause more side effects.
Regular skin checks are also important, since the skin can be affected by psoriatic arthritis. Watching for changes can help spot problems early.
Managing Emotional Support
People with psoriatic arthritis can seek help from family, friends, or support groups when symptoms such as swollen joints, back pain, and skin changes become difficult to manage.
Talking with a mental health professional can also ease feelings of depression or anxiety.
Support networks—including online forums and local meetings—help people find answers about occupational therapy, early treatment, and managing autoimmune symptoms.
Helpful resources:
- Family and friends
- Support groups
- Counselors or therapists
These resources can help build coping skills and improve quality of life for those managing chronic illnesses.
Getting Ready for Your Visit
Steps You Can Take Before the Appointment
Write down your symptoms, when they started, and if anything makes them better or worse. Keep a list of all medicines, vitamins, and supplements you are currently taking along with the doses.
Bring medical and family history, especially if anyone in your family has psoriatic arthritis, to help the rheumatologist understand your risk.
Prepare some questions to ask, such as the likely cause, what tests or treatments are needed, and if any lifestyle changes are suggested.
Here is a quick checklist:
| Task | Details |
|---|---|
| Bring a support person. | A friend or family member. |
| List symptoms and when they began. | Be as specific as possible. |
| Write medications and doses. | Include everything you take. |
| Note family history of similar conditions. | Especially psoriatic arthritis. |
| Prepare questions for the doctor. | Write them ahead of time. |
What Your Doctor Will Likely Ask
The rheumatologist will ask which joints hurt or are swollen. They may ask if certain activities or positions change your symptoms.
Be ready to explain what treatments or medicines you have tried. Let the doctor know if any have helped.
The doctor may also ask about your daily activities to understand how arthritis affects your life.
