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Arthritis and Chronic Joint SymptomsFrom the Centers for Disease Control Are you female, Caucasian, have a lesser education, and overweight? Then you run the greatest risk of either arthritis or chronic joint symptoms. Check out the latest statistics from the Centers...
Doctor, Help Me - How Do I Find Arthritis Pain Relief?
The first and most important activity a doctor must do when the patient comes in is to make an accurate diagnosis. This is done with a careful history, physical exam, laboratory tests, and imaging procedures. In the history, we ask questions such...
Rheumatoid Arthritis Causes
Arthritis is an inflammation of the joints. Rheumatoid arthritis is a chronic disease that can result in stiff joints that are deformed with loss of movement. This condition can affect anyone, any age, at any joint. What is the exact cause of...
My Dermatologist Told Me to See An Arthritis Doctor... I Have Psoriasis and My Joints Hurt...
Psoriatic arthritis is a distinct disease, different from rheumatoid arthritis and ankylosing spondylitis- another common type of arthritis- but sharing similar features to each. The disability and functional impairment in psoriatic arthritis can be as severe as that occurring from rheumatoid arthritis.
Typically, a patient will have had psoriasis for a number of years before the arthritis develops. A small proportion of patient will develop the arthritis concurrently with the skin disease and an even smaller percentage will develop the skin disease after the joint disease.
Psoriatic arthritis may affect most joints in an oligoarticular pattern, meaning a few scattered joints are affected and the joint inflammationdoes not have the symmetrical pattern seen in rheumatoid arthritis. Enthesitis, which is inflammation of the tendons that attach to bone, is common in psoriatic arthritis. “Sausage digits” – swelling of the fingers and toes so that they look like little sausages is frequent. Nail changes are also common. Some patients will develop carpal tunnel syndrome because of inflammation in the wrist. Inflammation of the eyes is a serious complication, as is involvement of the aortic valve of the heart.
Joint deformity is frequent and affects 40% of patients with the disease. Psoriatic arthritis has a significant impact on quality of life. The skin disease is a tremendous burden and often leads to depression.
The inflammatory process that causes both the skin disease as well as the joint disease is driven by elevated levels of a
substance called tumor necrosis factor, or TNF.
A patient with psoriasis who complains of joint pain, swelling, morning stiffness, and fatigue should raise a high level of suspicion for the diagnosis of psoriatic arthritis.
Laboratory testing will show evidence of inflammation and imaging procedures such as magnetic resonance imaging (MRI) can help confirm the diagnosis.
Treatments that improve the skin disease do not necessarily improve joint symptoms and vice versa.
Treatment goals include symptomatic relief and control of disease progression.
Non-steroidal anti-inflammatory drugs are helpful for relieving some symptoms. However the majority of patients with psoriatic arthritis will require a combination of methotrexate and anti-TNF biologic therapy. Anti-TNF therapies have provided a significant advance in the treatment of both the skin as well the joint disease in patients with psoriatic arthritis.
Dr. Wei (pronounced “way”) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: http://www.arthritis-treatment-and-relief.com
Written By: Nathan Wei
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