Psoriatic Arthritis
Psoriatic arthritis is a chronic disease characterized by inflammation of the skin - psoriasis - and joints - arthritis. It features patchy, raised, red areas of skin inflammation with scaling. Psoriasis often affects the tips of the elbows and knees, scalp, navel, and around the genital area. About 10 percent of patients who have psoriasis develop joint inflammation. Patients who have inflammatory arthritis and psoriasis are diagnosed as having psoriatic arthritis.
The onset of psoriatic arthritis generally occurs in middle age. The skin disease precedes arthritis in nearly 80 percent of patients.
What are the causes of psoriatic arthritis?
The cause of psoriatic arthritis is unknown. Experts believe a combination of genetic, immune, and environmental factors are involved. A genetic marker has been identified in some patients with psoriatic arthritis who have arthritis of the spine.
What are the symptoms of psoriatic arthritis?
Psoriatic arthritis is a systemic rheumatic disease that can also cause inflammation in body tissues beyond the joints, such as in the eyes, heart, lungs, and kidneys. Usually, only a few joints are inflamed at a time.
The inflamed joints become painful, swollen, hot, and red. Joint inflammation in the fingers or toes can cause swelling, which gives them a sausage appearance. Joint stiffness is common and is typically worse in early morning. Psoriatic arthritis can also cause inflammation of the spine, leading to pain and stiffness in the low back, buttocks, neck and upper back.
Inflammation of the tendon behind the heel causes Achilles tendinitis and pain when walking and climbing stairs. Inflammation of the chest wall and of the cartilage linking the ribs to the breastbone can cause chest pain. Other common symptoms are acne and nail changes.
Diagnosing Psoriatic Arthritis
Other than genetic testing to determine if the genetic marker is present, there is no laboratory test to diagnose psoriatic arthritis. Rather, we diagnose psoriatic arthritis by the presence of psoriasis and inflammatory arthritis of the spine and joints. Blood tests can exclude certain conditions such as rheumatoid arthritis.
When one or two large joints, such as knees, are inflamed, we can perform an office procedure to withdraw and analyze fluid for infection, gout crystals, and other inflammatory conditions. X-rays may show changes of cartilage or bone injury that indicates arthritis.
A thorough diagnosis involves obtaining a detailed history of your condition and performing an examination of your spine and the surrounding area. To ensure the most accurate diagnosis, we also offer such options as open MRIs, and CT scans.
Treating Psoriatic Arthritis
Psoriatic arthritis treatment is complex and highly individualized for each patient. Simple steps are the use of anti-inflammatory drugs and supervised exercise. Treatment options include exercise physiology; aquatic therapy; functional capacity evaluations; spinal manipulation; and a number of more aggressive therapies as needed.
In addition, we embrace non-traditional treatments such as acupuncture, chiropractic care, meditation/relaxation, and Qui-Gong. Our goal is to return you to good health without pain.