Blood tests can help to diagnose psoriatic arthritis (PsA) or to rule out other conditions that cause similar symptoms. Regular blood tests are also used to: monitor disease activity. check if your PsA treatment is working.
In the absence of a definitive diagnostic test for psoriatic arthritis (PsA), your health care provider will diagnose you by examining your skin, nails, joints and other symptoms. You may have X-rays, an MRI, an ultrasound and blood tests as well.
Psoriatic Arthritis Blood Test: Anti-Cyclic Citrullinated Peptide Test. Blood tests that look for the presence of anti-cylic citrullinated peptide antibodies (anti-CCPs), which are inflammatory, are commonly used to diagnose rheumatoid arthritis, but anti-CCPs can also indicate psoriatic arthritis.
Diagnosing psoriatic arthritis
If the GP thinks you may have psoriatic arthritis, they should refer you to a rheumatologist (a specialist in joint conditions) for an assessment. A rheumatologist will usually be able to diagnose psoriatic arthritis if you have psoriasis and problems with your joints.
Unfortunately, that's fairly common with this disease, which is often invisible. "There's no one test that can diagnose or rule out psoriatic arthritis, which is why, at times, it can be difficult to diagnose," says Rebecca Haberman, a rheumatologist at NYU Langone Health.
PsA is often undiagnosed and can be misdiagnosed for rheumatoid arthritis (RA) or osteoarthritis (OA), especially in a non-rheumatologic setting [7–9]. RA is a chronic inflammatory arthritis typified by pain, swelling, and stiffness of the joints, particularly symmetric small-joint synovitis of the hands and feet [10].
Early signs of PsA include swelling in the fingers, eye inflammation, fatigue, nail changes, and joint stiffness. PsA usually occurs in people who already have psoriasis, but it can also develop independently. It causes joint pain and inflammation.
“Worsening joint pain and swelling, or new or worsening psoriatic lesions, are the most common red flags that someone is having a PsA flare,” says Yamen Homsi, M.D., the section chief of rheumatology at NYU Langone Hospital in Brooklyn, NY. But there may be other signs that a flare is on the way.
Both psoriatic arthritis and fibromyalgia can result in pain and fatigue, but people with psoriatic arthritis have these symptoms that differentiate the condition from fibromyalgia: Tender, swollen joints. The swelling of a whole toe or finger, referred to as “sausage digits”
The Arthritis Foundation lists joint pain, stiffness, skin rashes, fatigue, nail changes, decreased range of motion, and swelling as some of the symptoms of psoriatic arthritis. When you combine these problems, the results can be debilitating. “It's like feeling your bones shatter and crumble.
So, basically rheumatoid arthritis and psoriatic arthritis are very similar and treatments are generally the same. The biggest difference is the joints involved in the hands and feet and the fact that psoriatic arthritis also involves psoriasis of the skin which is a persistent chronic disease in itself.
Rheumatologists often prescribe nonsteroidal anti-inflammatory drugs, also known as NSAIDs, to people with psoriatic arthritis. These medications can help ease pain and curb the swelling that accompanies this condition. Common NSAIDs include aspirin, ibuprofen, and naproxen.
The majority of cases begin with the skin condition and then progress to joint pain within seven to 10 years.
Psoriatic arthritis causes inflamed, swollen, and painful joints. It happens most often in the fingers and toes.
Rheumatoid arthritis and psoriatic arthritis are both autoimmune disorders that cause inflammation in the joints and throughout the body. Rheumatoid arthritis, like PsA, causes the synovial tissues that line the joints to thicken, causing pain, tenderness and swelling.
“Psoriatic arthritis is a systemic inflammatory condition,” Gupta says. “Left untreated, it can result in fatigue and a general feeling of sickness. It can also result in anemia due to prolonged inflammation.” Anemia can be an independent reason for fatigue and can be resolved with treatment, adds Gupta.
The takeaway. PsA causes painful joint and skin symptoms, which can reduce quality of life and interfere with daily activities. The pain tends to be worse when the condition is active. Doctors may prescribe one or more DMARDs to reduce disease activity and relieve symptoms such as pain.
What does psoriatic arthritis look like on the hands? Common symptoms include pain, swelling, and “sausage” fingers, which may appear shortened. An X-ray may show a “pencil-in-cup” deformity, where the middle of a finger bone becomes narrow while the end of the bone takes on a cup shape.
A study published in 2015 in the journal PLoS One found that the overall pain, joint pain, and fatigue reported by psoriatic arthritis patients was significantly greater than that reported by people with rheumatoid arthritis.
Foods like fatty red meats, dairy, refined sugars, processed foods, and possibly vegetables like potatoes, tomatoes, and eggplants (you might hear them called nightshades) may all cause inflammation. Avoid them and choose fish, like mackerel, tuna, and salmon, which have omega-3 fatty acids.
Swelling around the ankle is common in psoriatic arthritis affecting the foot. Psoriatic arthritis can lead to shortening or clawing of the toes, hyperextension of the big toe and some in-rolling of the ankle with flattening of the metatarsal arch.
You'll probably think of skin issues first, but your eyes, heart, lungs, gastrointestinal (GI) tract (stomach and intestines), liver and kidneys may also be affected.
PsA Is an Autoimmune Disease
The inflammation can affect the entire body and may lead to permanent joint and tissue damage if it is not treated early and aggressively.