Psoriatic Arthritis - Health Center

Psoriatic Arthritis

By Refadoc, Posted on : Tuesday, 15 September 2015 - 10:46 am IST

Psoriatic Arthritis: Basic Overview

As it’s evident from the name, Psoriatic Arthritis is a form of arthritis which affects the people who suffer from Psoriasis, an acute skin condition that leads to red patches of skin accompanied by silvery scales all over the body. A lot of people develop psoriasis first and are then later on diagnosed with arthritis. However, in some cases, the joint problems can appear before the manifestation of the skin lesions.

Some of the major symptoms of Psoriatic Arthritis are joint pains, stiffness around the joints as well as inflammation. This condition can affect any part of the body, including the fingertips as well as the spinal cord. The symptoms can range from very mild to severe and the disease flares can appear alternatively between periods of remission.

There is no known cure for Psoriatic Arthritis. However, treatment options are in place for controlling the symptoms and thus preventing any damage to the joints. Without any treatment options, the disease can prove disabling to many. 

Causes of Psoriatic Arthritis:

Psoriatic Arthritis occurs when the immune system of the body affects the healthy tissues and cells of the body, unlike its usual function. This abnormal response of the immune system tends to cause inflammation around the affected joints as well as leads to the overproduction of the skin cells around the affected region.

Researchers have not been able to determine the reason behind this abnormal response by the immune system. However, genetics as well as environmental factors are known to play a major role behind this response. It has been found out that many people suffering from Psoriatic Arthritis have either a family history of the condition of either psoriasis or psoriatic arthritis. Certain genetic markers have been found out that appear to be related directly with psoriatic arthritis.

Physical traumas, viral and bacterial infections are known to trigger Psoriatic Arthritis in people with a hereditary history of the same. 

Symptoms of Psoriatic Arthritis:

Psoriatic Arthritis, just like simple arthritis, is a chronic disease, i.e. it tends to get worse with time. There may be periods when the symptoms improve drastically and the patient might go into remission. However, this soon subsides and the symptoms tend to get worse later on. Psoriatic Arthritis affects the joints on either one side or both the sides of the body. The disease can cause the joints to become swollen and inflamed. Some of the major symptoms are as follows:

  1. Swollen fingers and toes: Psoriatic Arthritis causes the fingers and toes to become swollen and painful. Some patients may even develop swelling and inflammation on the hands along with deformities in the major joints of the body.
  2. Pain in the foot: Patients are also likely to develop pain at the points where the tendons and the ligaments are attached to the bones. Pain at the back of the heel (Achilles Tendinitis) or on the sole of the foot (Plantar Fasciitis) is a major occurrence in people suffering from Psoriatic Arthritis.
  3. Lower Back Pain: A lot of patients develop a condition known as Spondylitis, as a result of this condition. Spondylitis causes an inflammation in the joints of the vertebrae of the spine as well as within the joints of the spine and the pelvis.

It is recommended to see a doctor if you have been suffering from Psoriasis and then develop joint pain. The condition can develop suddenly or gradually, but can cause tremendous damage to the joints if ignored and left untreated. 

Tests and Diagnosis of Psoriatic Arthritis:

A physical examination is the best way to determine the condition. During the examination, the doctor may examine the joints for the signs of swelling or tenderness. He may also check your fingernails for signs of flaking or other abnormalities. Often, the soles of the feet or around the heels are pressed in order to look for tenderness. There is no single test for diagnosing the condition. However, there are a series of tests which can point the finger towards the condition.

Imaging Tests:

  1. X rays: X Rays are used in order to look for any changes in the joints of a patient suffering from the condition.
  2. MRI: Magnetic Resonance Imaging uses the radio waves along with a strong magnetic field in order to produce very detailed images of the joints as well as the soft tissues in the body. This test is used in order to check for any problems related to the tendons and the ligaments in the feet as well as the lower back.
  3. Rheumatoid Factor (RF): RF is an antibody which is present in the blood sample of people affected with Rheumatoid Arthritis. This test removes the possibility of Rheumatoid Arthritis in case of a patient suffering from Psoriatic Arthritis.
  4. Joint Fluid Test: This test is done with the help of a long needle via which the doctors can remove a small sample of fluid from the affected joints of the patient. Uric Acid crystals in the joint fluid, if any, can indicate the possibility of gout rather than Psoriatic Arthritis. 

Treatment and Drugs for Psoriatic Arthritis:

There is no known cure for Psoriatic Arthritis. However, medications and surgical procedures are in place to reduce and control the symptoms and the inflammation which is associated with the condition. The treatment options are as follows:

Medications:

1.   NSAID’s: Non Steroidal Anti Inflammatory Drugs are used in order to relieve the pain and inflammation. NSAID’s such as Ibuprofen, Naproxen Sodium are the most popular, though the side effects may include stomach irritation, heart and liver problems etc.

2.   DMARD’s (Disease Modifying Anti rheumatic Drugs) are known the slow down the progression of the disease and save the joints from deformity and degradation. Some of the common DMARD’s are methotrexate, leflunomide and Sulfasalazine.

3.   Immunosuppressant: These medications work on the immune system and control the condition. Medications such as Azathioprine and Cyclosporine can increase the susceptibility towards infections.

4.   TNF- Alpha Inhibitors: Tumor Necrosis Factor Alpha is an inflammatory substance which is produced by the body. However, these medications reduce the pain, stiffness as well as swelling over the affected joints. Medications such as etanercept, infliximab as well as golimumab are the best used over the counter TNF alpha inhibitors.

Surgical Procedures:

1.   Steroid Injections: This kind of medication reduces the inflammation across the affected regions and injection is given directly to the affected joint.

2.   Joint replacement surgery: In some of the severe cases of Psoriatic Arthritis, where the joints have been damaged seriously, the joints are replaced by artificial prostheses made up of metal and plastic.

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