Psoriatic Arthritis (PsA) presents with symptoms such as pain, swelling, or stiffness in one or more joints, often asymmetric. Typically large joints of lower extremities may be affected, but it can also involve small joints of fingers and toes, and as well as the spine and sacroiliac joints. PsA is usually seen in adults around age 30-50 who also have been diagnosed with skin psoriasis – a skin rash topped with silvery scales.
PsA can be challenging to diagnose due to its diverse clinical manifestations and the absence of definitive diagnostic tests. While there are no definitive lab tests for PsA, certain tests can help rule out other types of arthritis. These include rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) tests, which are usually negative in PsA. Elevated levels of inflammatory markers like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) may also suggest PsA. Various imaging techniques including Xrays, Ultrasound or MRI may be beneficial to detect bone erosions, synovitis, enthesitis, and dactylitis – hallmarks of PsA.
Early diagnosis and appropriate treatment of PsA can significantly improve a patient's quality of life and prevent disease progression and permanent joint damage.
Usually, non-steroidal anti-inflammatory medications are recommended along with possible local intraarticular corticosteroid joint injection for symptomatic relief of joint pains. It is also important to treat the underlying disease process with a disease-modifying antirheumatic drug. These include medications such as Methotrexate or Leflunomide and/ or Biological response modifiers that target specific parts of the immune system to inhibit joint inflammation. Currently approved biological treatments for Psoriatic Arthritis include TNF inhibitors, Interleukin inhibitors, T-cell inhibitors, Janus Kinase inhibitors, and PDE4 inhibitors.
The choice of DMARD/ Biologic treatment depends on various factors, including the patient's overall health, severity of their symptoms, their response to previous treatments, and potential side effects of the medication. It is important to discuss all available treatment options with your physician to determine the most suitable treatment plan for you.
If you are experiencing symptoms of joint pain and are seeking an accurate diagnosis and comprehensive treatment plan, contact Dr. Veena Nayak at Southland Rheumatology Center.
We will complete a thorough evaluation, with state-of-the-art diagnostic blood tests and imaging to accurately diagnose your arthritis. We will utilize an integrative approach targeted toward the treatment and prevention of arthritis and relief of your joint pain.
