It is sometimes linked to a second kind of psoriatic disease calledpsoriasis, which primarily affects the skin.
Some people will have both PsA and psoriasis, while others with PsA may never get psoriasis.
What causes PsA is unknown, but researchers believe there is a genetic component to PsA.
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In addition, certain external factors might contribute, includinginfection, physical trauma, smoking, and chronic stress.
BSIP / Getty Images
No cure exists for PsA, but it is a treatable and manageable condition.
Treatment can help to controlinflammationand prevent joint damage and disability.
PsA affects all sexes equally and generally develops between the ages of 30 and 50.
This article will cover PsA symptoms, differential diagnosis, diagnostic tools, misdiagnosis, and more.
It is possible to experience joint symptoms first.
And some people will never have psoriasis or skin symptoms related to PsA.
These plaques are covered with silvery-white scales.
Plaques can be itchy, painful, and inflamed.
They can also bleed and crack.
For some people, the condition will start gradually and slowly worsen.
For others, it might come on suddenly and become painful and severe very quickly.
Like PsA, RA might affect internal organs.
Left untreated, RA and PsA can lead to joint damage, mobility and function troubles, and disability.
Both conditions can cause similar complications, such as life-threatening infections, heart disease, and lung problems.
The two conditions are treated similarly, withdisease-modifying antirheumatic drugs(DMARDs) andbiologics.
Also, RA rarely causes a skin rash or nail symptoms.
Gout and Pseudogout
Gout andpseudogoutare types of arthritis triggered by the accumulation of crystals in the joints.
Gout is due to uric acid crystals and pseudogout by calcium pyrophosphate crystals.
Symptoms of gout and pseudogout include intermittent episodes of red, hot, and swollen joints.
These attacks often start in the middle of the night.
People with PsA can suddenly develop joint symptoms, just like people with gout or pseudogout.
And people with PsA can have one swollen toe or one swollen finger.
People with PsA have a higher risk of developing gout.
OA causes some joint symptoms similar to those seen in PsA.
PsA vs. OA
OA and PsA have more differences than they do similarities.
Reactive Arthritis
PsA and reactive arthritis are types ofspondyloarthritis, arthritis conditions that affect the spine.
It islinked to the HLA B27 gene.
Like PsA, reactive arthritis can cause asymmetric pain in the lower back and lower limbs.
It can also cause enthesitis and dactylitis.
Reactive arthritis might also cause eye inflammation.
Reactive arthritis also causes urinary tract inflammation, which is rarely seen in PsA.
This isn’t the case for PsA, which is lifelong and will progressively become worse.
Septic Arthritis
Septic arthritis is an infection of the synovial (joint) fluid and joint tissues.
It is common in children, but it can also affect adults.
Different types of bacteria, viruses, and fungi can affect the joint when they enter the bloodstream.
Septic arthritis causes similar symptoms to PsA, including joint pain and swelling.
Much like PsA, untreated septic arthritis can lead to permanent joint damage.
Septic arthritis generally presents with fever, and PsA usually does not.
Lastly, septic arthritis is treatable with antibiotics, and symptoms often do not return.
But PsA is a chronic condition that requires lifelong treatment.
The two types of axSpA arenon-radiographic axial spondyloarthritis(nr-axSpA) andankylosing spondylitis(AS).
AxSpA conditions might also cause dactylitis and enthesitis.
For example, AS primarily affects the spine.
While spine involvement can occur in PsA, PsA mainly affects the peripheral joints, shoulders, and hips.
PsA also frequently affects the fingers and toes and causes skin and nail symptomssymptoms rarely seen in axSpA.
Heel pain can also occur in PsA.
But in PsA, plantar fasciitis occurs because of enthesitis in areas where ligaments attach to bone.
PsA vs. Plantar Fasciitis
Plantar fasciitis, on its own, is limited to the plantar fascia.
But PsA causes enthesitis at the plantar fascia because of your immune systems overactive response.
Your healthcare provider will employ different diagnostic tools to determine the cause of symptoms.
Of course, having a family history does not mean you will develop either condition.
And getting PsA without any personal or family history is also possible because gene mutations can sometimes be sporadic.
The skin and nails are examined for skin plaques, lesions, and nail symptoms.
Lab Work
There is no single blood test that confirms PsA.
Imaging in PsA can be beneficial.
Different types of imaging can identify patterns of what is going on with your joints.
An MRI can offer more detailed imaging, including visualization of the entheses and hip joints.
Ultrasound can pinpoint inflammation and is sensitive enough to detect joint damage early.
There were many reasons why PsA might be misdiagnosed, according to the researchers.
When to See a Healthcare Provider
PsA is a progressive disease that will worsen with time.
And if it is not adequately treated, it could lead to life-threatening complications.
It is vital to get a timely diagnosis and start treatment early to avoid joint and bone damage.
And even without personal or family history, it is still important to reach out early.
PsA shares symptoms with other types of arthritis, so diagnosing it requires a differential diagnosis approach.
A thorough diagnosis will involve a physical examination, blood work, imaging, and more.
Misdiagnoses are common PsA.
It is good to be proactive so that PsA is not missed and treatment is not delayed.
A Word From Verywell
Diagnostic delays in psoriatic arthritis can lead to irreversible joint damage.
That means it is crucial to identify the condition early as possible and start treatment immediately.
It is also vital to take your PsA medication consistently and as directed by your healthcare provider.
This is the best way to prevent the disease from progressing.
Be sure to discuss all your options with your healthcare provider and your ability to stick with that plan.
It tends to be asymmetric, although people with advanced disease might experience a symmetric disease pattern.
No single test can confirm a psoriatic arthritis diagnosis.
You should also share any personal or family histories of psoriatic disease with your healthcare provider.
There is no cure for psoriatic arthritis, but it is possible to experience disease remission.
That means you still have PsA, but you have no symptoms or very little disease activity.
It is possible to achieve remission with the help of medication, including DMARDs and biologics.
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