Tuesday, 19 September 2017

Why Spotting Psoriatic Arthritis Early On Is Key

Psoriatic arthritis often goes undiagnosed, but identifying signs of the disease early on could lead to significantly better outcomes.

“Early diagnosis means an opportunity to initiate early treatment, which can improve the symptoms of arthritis,” says Lihi Eder, MD, PhD, a rheumatologist from the University of Toronto and Women’s College Hospital Research Institute in Canada.

The Dangers of Waiting

Research shows that putting off treatment can result in permanent joint damage for people with psoriatic arthritis.

A study published in February 2014 in the journal Annals of the Rheumatic Diseases found psoriatic arthritis patients who had a delayed diagnosis of more than six months had worse bone and joint deterioration and didn’t respond as well to treatment.

A delay of more than a year reduced a person’s chance of experiencing drug-free remission.

“Many of the available treatments can prevent the development of joint damage as a result of arthritis,” Dr. Eder says.

Biologic drugs, which target certain parts of the immune system, have been shown to slow or stop joint damage in people with psoriatic arthritis if they’re given early.

A Difficult Diagnosis

In a paper published in August 2015 in the Journal of the American Academy of Dermatology, investigators found about 15 percent of psoriasis patients have undiagnosed psoriatic arthritis.

“Diagnosis can be tricky,” says Arthur Kavanaugh, MD, professor of medicine at the University of California in San Diego School of Medicine. “About 25 percent of patients with psoriasis will get the inflammatory arthritis that we call psoriatic arthritis, yet almost all humans will have occasional pains in and around the joints, and almost all will eventually develop non-inflammatory arthritis (osteoarthritis) in some joints.”

Psoriatic arthritis can also produce symptoms that mimic those of other conditions. To further complicate matters, there’s no single diagnostic test to identify psoriatic arthritis.

“The physician is taking into consideration many factors when making the diagnosis,” Eder says.

Know the Symptoms

Some signs of psoriatic arthritis to watch out for include:

  • Pain, stiffness, swelling, or tenderness in and around the joints
  • Fatigue
  • Swollen fingers and toes
  • Morning stiffness
  • Nail changes
  • Wrist, lower back, knee, or ankle pain
  • Pain or redness in the eye
  • Psoriatic arthritis can develop slowly or quickly, and symptoms may be mild or severe.

For about 85 percent of people, psoriasis happens before the joint disease. But, there’s no link between the severity of the psoriasis and the severity of the psoriatic arthritis.

The bottom line: If you have psoriasis and start to experience aches and pains, let your doctor know right away.

“Work with your healthcare provider to assess persistent joint problems,” Dr. Kavanaugh says.

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