Heighten your psoriatic arthritis awareness and hone your approach for supporting patients as Versus Arthritis presents the condition’s causes, diagnosis details, and latest research.

As there are many forms of cancer and neurological conditions, there is no single form of arthritis; although ‘arthritis’ can be a general term people reference when discussing joint pain. The word arthritis is used to describe pain, swelling and stiffness in a joint or joints.

Arthritis isn’t a single condition and there are several different types. There can be an overlap between how other conditions present and arthritis. People with a severe form of the dermatological condition psoriasis may also risk developing psoriatic arthritis which affects the joints. Due to how it presents itself, psoriatic arthritis can be mistaken for rheumatoid arthritis, osteoarthritis or gout.

Not everyone who has psoriasis will develop psoriatic arthritis. However, if joint pain becomes a concern within a few years of diagnosis of psoriasis, psoriatic arthritis may be the underlying cause. This is a sign to be aware of but there is no definite pattern to discovering that someone has the condition.

Causes

Knowledge of family history is important for patients to be correctly diagnosed. Some people may already be at risk of this type of arthritis because of genetics. Research suggests that an infection possibly acts as a trigger for psoriatic arthritis, but no specific infection has yet been identified. A variety of infections could possibly trigger the condition; for example, bacteria living in patches of psoriasis.

Pain and Discomfort from Joint Inflammation

Psoriatic arthritis can affect any one of 78 major joints in the body – although some joints are more likely to be impacted than others.

The effect of inflammation on the immune system is a factor in both psoriasis and psoriatic arthritis. Each condition requires appropriate treatment to alleviate pain and discomfort in the joints.
Signs and Symptoms

People who have symptoms of psoriatic arthritis are referred to a rheumatologist who will make a diagnosis according to the signs and symptoms, which include a red, scaly rash; swollen, stiff and painful joints; swelling of fingers or toes (dactylitis). There may also be a thickening, discoloration and pitting of the fingernails. Pain and swelling at the back of the heel may also be present. People with many forms of arthritis can often experience fatigue.

Lifestyle choices can contribute to the development of psoriatic arthritis. Among these can be smoking, obesity and a lack of regular physical activity.
Diagnosis

Blood tests, such as those for rheumatoid factor and the anti-CCP antibody, can help determine if someone has psoriatic arthritis. People with the condition tend not to have these antibodies in their blood, but people who have rheumatoid arthritis are more likely to test positive for them.

These tests can’t confirm beyond doubt whether someone has psoriatic arthritis, but they can help when taking everything else into account. X-rays of your back, hands and feet may help because psoriatic arthritis can affect these parts of the body in a different way to other conditions. Other types of imaging, such as ultrasound scans and magnetic resonance imaging (MRI), may help to confirm the diagnosis.
Treatments

Once a diagnosis has been made, topical treatments like ointments or light therapy may be used to treat psoriasis, while non-steroidal anti-inflammatory drugs (NSAIDs) can relieve pain and stiffness, or disease-modifying anti-rheumatic drugs (DMARDs) may be prescribed. These act on the causes of inflammation and may be prescribed to treat joint inflammation.

Upcoming Research to Support Patients and Non-Clinical Research

Versus Arthritis funded research into genetic differences in people with psoriatic arthritis, compared to psoriasis and rheumatoid arthritis.

This work, by the Centre for Genetics and Genomics at the University of Manchester, will help to establish psoriatic arthritis as a condition in its own right. The benefit of these findings could lead to the development of drugs specifically for the condition.

The TIght COntrol of Psoriatic Arthritis trial will look at the benefits of early aggressive drug treatment for people with psoriatic arthritis, followed by an increase in drug dosage if initial treatment isn’t working. It’s hoped that patients treated in this way will require fewer hospital and community-based services than patients receiving the standard care.

Non-clinical studies funded by Versus Arthritis include research at the University of Glasgow into whether the molecule IL-37 can reduce inflammation in psoriatic arthritis and other inflammatory forms of the condition. If so, the molecule can be used to develop new treatments.

Living Healthier Lives with Psoriatic Arthritis

Like all forms of arthritis, psoriatic arthritis is a serious condition and people who are concerned about signs and symptoms should seek advice from their healthcare provider about individual treatment which is right for them. More information about how psoriatic arthritis can affect individuals can be found by visiting www.versusarthritis.org/about-arthritis/conditions/psoriatic-arthritis.

Both patients and healthcare providers can also access practical advice about additional support, including biological therapies, treatment pathways and more information about the latest research.

Further Guidance

More information about Versus Arthritis-funded research and research centres can be found by visiting www.versusarthritis.org/research/our-current-research/our-research-centres.

People who have psoriatic arthritis or who would like more information, help and guidance can contact the Versus Arthritis helpline by calling 0800 5200 520 for free (Monday-to-Friday; 9am-to-8pm).