ARTHRITIS, PSORIATIC

Both psoriatic arthritis and psoriasis are long-term diseases that progress after some time, yet you may have periods when your symptoms may improve or have remission.

Psoriatic arthritis can affect joints on only one side or on the two sides of your body. The signs and symptoms are similar to that of rheumatoid arthritis. The two diseases cause joints to be painful, swollen and warm to the touch.

However, psoriatic joint inflammation can likewise cause:

Swollen fingers and toes

Psoriatic arthritis can cause an excruciating painful swelling of your fingers and toes. You may likewise have swelling and disfigurements in your hands and feet before having  joint manifestations.

Foot pain

Psoriatic joint inflammation can likewise cause pain at the focuses where ligaments and tendons connect to your bones, particularly at the back of your heel, also called Achilles tendinitis or in the bottom of your foot, also known as plantar fasciitis.

Lower back pain

A few people have a condition called spondylitis because of psoriatic arthritis. Spondylitis mostly causes inflammation of the joints between the vertebrae of the spine and the joints between your spine and pelvis or sacroiliitis.

DIAGNOSIS

The doctor may inspect your joints for swelling and tenderness. He or she may also check your fingernails for pits, flakes or other deformities. The soles of your feet may be pressed to discover if there are tender areas.

There is no single test that can diagnose psoriatic arthritis. Some tests can rule out the other reasons for joint pain, for example, rheumatoid arthritis or gouty arthritis.

Imaging tests

Your doctor may also request for these imaging tests:

• X-ray to help determine if there are changes in the joints that are present in psoriatic arthritis
• Magnetic resonance imaging (MRI) uses radio waves and magnets to deliver images of both hard and soft tissues in your body. This kind of imaging test may check for issues with the ligaments and tendons in your feet and lower back.

Laboratory tests

Rheumatoid factor (RF) is an antibody that is regularly present in the blood of individuals with rheumatoid arthritis, but not in the blood of individuals with psoriatic arthritis. Therefore, this test can enable your doctor to recognize between the two conditions.

Joint fluid examination. Utilizing a needle, your doctor will remove a sample of your joint fluid from your affected joints,  frequently the knee. Uric acid crystals in your joint fluid may show that you have gout instead of psoriatic arthritis.

TREATMENT

There is no real treatment for psoriatic arthritis, so treatment centers around controlling inflammation in your joints.

Medications that may be given for psoriatic arthritis may include the following:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) that can relieve pain and decrease
• Disease-modifying antirheumatic drugs (DMARDs)that can slow down the progress of psoriatic arthritis and decrease permanent damage in the joints
• Immunosuppressants to control your immune system
• TNF-alpha inhibitors such as Tumor necrosis factor-alpha (TNF-alpha) which can help reduce pain,  stiffness, swelling and tenderness
• Newer medications such as apremilast, ustekinumab and secukinumab

Surgery and other procedures

• Steroid injection scan decrease inflammation
• Joint replacement surgery can replace affected joints with artificial prostheses that may be made of metal or plastic