April 11, 2008

Diagnosis of Psoriatic Arthritis

Posted in Category : Bone, Joint & Muscles Disorders

Early diagnosis of any disease is very important for appropriate treatment. This is true in case of inflammatory type of arthritis known as psoriatic arthritis which is related with psoriasis, a chronic skin disease. It affects various joints of ankle, knees, feet, hands and fingers and causes inflammation of joints which results in swollen, red, warm and painful joints. Some causes of psoriatic arthritis include hereditary, environmental factors and immunological abnormalities.

Early diagnosis of psoriatic arthritis is very essential as it can cause serious joint damage and deformities. If you experience the pain or tenderness in joints as well as nail or skin problems, then consult with the doctor. The diagnosis of psoriatic arthritis may be difficult as early symptoms of this disorder may be mild. The doctor examines the joints and asks few questions about the symptoms and family history.

Diagnosis of psoriatic arthritis is based on symptoms, typical inflammatory arthritis of the spine or other joints and finding of psoriasis. The changes in nails and skin that are typical of psoriasis are demonstrated and sometimes, skin biopsies are done.

There are no specific laboratory tests to diagnose this disease. The tests such as determination of levels of erythrocyte sedimentation rate (ESR) and levels of uric acid are performed. The elevated levels of ESR suggest the presence of joint inflammation and inflammation of other body parts. Some blood tests are performed to rule out the presence of other types of arthritis. For example, determination of rheumatoid factor is done to detect the possibility of rheumatoid arthritis. The blood test for HLA-B27, a genetic marker, is also recommended for the patients with psoriatic arthritis.

When there is an inflammation of one or two large joints such as knees, arthrocentesis is performed which involves aspiration of fluid from the inflamed joints with the help of a sterile needle. Analysis of this fluid is done for the presence of gout crystals, infection and other inflammatory conditions.

X-ray findings contribute a lot in the diagnosis of psoriatic arthritis and help to distinguish psoriatic arthritis from other forms of arthritis. Typical x-ray findings include the changes in cartilage or bone injury that indicates the arthritis of sacroiliac joints, spine and hands. CT scan of pelvis is recommended if there is an inflammation of hip, pelvis or spine. MRI scan is performed to assess the involvement of joints especially of feet and hands.

After the accurate diagnosis of psoriatic arthritis, various treatment options such as medications and exercise are suggested by the physicians.