Getting Tested For Psoriatic Arthritis
Testing for psoriatic arthritis is ordered by your doctor or a specialist, such as a rheumatologist, a doctor who specializes in joint diseases, or a dermatologist, a doctor whose specialty is treating the skin. Blood and urine specimens used in testing can be provided in a doctors office or laboratory.
Synovial fluid analysis involves collecting a small amount of joint fluid using a process called arthrocentesis. During this procedure, a needle is used to withdraw fluid from the space around a joint. It is usually done at a doctors office.
Some diagnostic imaging tests, like x-rays, may be done in a doctors office. Others may need to be performed at an imaging center or hospital radiology department.
The Role Of Psoriatic Arthritis Tests
Psoriatic arthritis testing is used to help diagnose the disease, to evaluate your suitability for certain treatments, and to monitor for treatment effects.
No single test can diagnose or rule out psoriatic arthritis. This disease is diagnosed by a physician who uses a range of information, including:
- Family and medical history
- Heel pain
- Swollen fingers or toes
If you have symptoms of psoriatic arthritis, it is a good idea to discuss your concerns with your doctor. Early diagnosis and treatment can help prevent the severe joint damage that may occur if the disease progresses.
Psoriatic Arthritis Symptoms: Spot The Signs
Psoriatic arthritis can cause different symptoms from person to person. But there are several common symptoms:
- Psoriasis and pitting of your nails.
- Painful, swollen joints, most commonly in your hands, feet, wrists, ankles and knees.
- Reduced range of motion and stiffness in your joints, especially in the morning.
- Digestive disorders like inflammatory bowel disease.
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Mediterranean Diet Requires More Research
People who follow this diet get most of their fat from extra-virgin olive oil. They also eat at least two servings of vegetables and three servings of fruit every day. Each week, they eat at least three servings of fish or seafood, beans, and nuts.
All of these foods are rich in anti-inflammatory nutrients. Because psoriasis causes inflammation throughout the body, its believed that this diet could lead to less psoriasis on your skin.
Its still too early to know whether this is true. However, one large study suggests a Mediterranean diet could help people with psoriasis. In this study, 35,735 patients were asked to answer surveys about what they ate. The researchers collected in-depth information, such as how much fresh fruit and vegetables, fish, and legumes they ate.
The patients answered these in-depth surveys three times over a six-month period.
After analyzing the results, the researchers found that the patients with severe psoriasis ate few if any foods found in the Mediterranean diet.
While this may suggest that following a Mediterranean diet can lessen the amount of psoriasis on your skin, its too soon to tell. Only about 2% of the patients in this study had psoriasis. The study also relied on people being able to recall what they ate. Sometimes, it can be difficult to remember what you ate yesterday let alone weeks ago.
Takeaway: More research is needed to know how the Mediterranean diet affects psoriasis.
Talk With Others Who Understand
MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, nearly 100,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.
Have you experienced psoriasis spreading? Share your experience in the comments below, or start a conversation by posting on MyPsoriasisTeam.
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What Treatments Can I Have If I Have Eczema Or Psoriasis
When it comes to the spa, there are some treatments that could soothe and potentially improve your condition. As stress is one of the potential triggers for flare-ups, a relaxing spa day might also help to control your symptoms.
In particular, any treatments involving minerals and mud can be beneficial for problem skin. Also, dont rule out a massage. Some of the carrier oils and essential oils can really help to soothe psoriasis. However, it is important to tell the therapist beforehand, so they can select massage oils that will improve, not irritate, any areas of sore skin. Theres no definitive safe list of essential oils. However, bergamot, clary sage, tea tree, lavender, chamomile, geranium, and rose are a few potentially calming and soothing oils to use in a treatment. Shea butter is also often used in massage treatments for those with dry and inflamed skin.
Its a good idea to pop in for a patch test a couple of weeks before your spa day, to see how your skin reacts to the products. Most spas offer personalised, tailored treatments, so your therapist can adapt the treatment to accommodate your condition. If youre really uncertain how your skin will react to the spas products, bring your own tried and tested products.
Imaging Tests For Psoriatic Arthritis
Imaging tests can help your doctor closely examine your bones and joints. Some of the imaging tests your doctor may use include:
- X rays. X-rays arent always useful in diagnosing early stage psoriatic arthritis. As the disease progresses, your doctor may use imaging tests to see changes in the joints that are characteristic of this type of arthritis.
- MRI scans. An MRI alone cant diagnose psoriatic arthritis, but it may help detect problems with your tendons and ligaments, or sacroiliac joints.
- CT scans. These are used primarily to examine joints that are deep in the body and not easily seen on x-rays, such as in the spine and pelvis.
- Ultrasounds. These tests can help determine the progression of joint involvement and pinpoint the location.
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What If Those Psoriasis Treatments Dont Work
If psoriasis doesnt improve, your healthcare provider may recommend these treatments:
- Light therapy: UV light at specific wavelengths can decrease skin inflammation and help slow skin cell production.
- PUVA: This treatment combines a medication called psoralen with exposure to a special form of UV light.
- Methotrexate: Providers sometimes recommend this medication for severe cases. It may cause liver disease. If you take it, your provider will monitor you with blood tests. You may need periodic liver biopsies to check your liver health.
- Retinoids: These vitamin A-related drugs can cause side effects, including birth defects.
- Cyclosporine: This medicine can help severe psoriasis. But it may cause high blood pressure and kidney damage.
- Immune therapies: Newer immune therapy medications work by blocking the bodys immune system so it cant jumpstart an autoimmune disease such as psoriasis.
Genes Within The Mhc Region
Polymorphisms in the genes coded in the HLA region on chromosome 6p have been shown to be associated with PsA. This dense region codes for a number of genes important in the immune response, including HLA and non-HLA alleles. Class I antigens have consistently shown a positive association with psoriasis and PsA. While HLA-B13, -B16, and its splits -B38 and -B39, B17, and Cw6 are associated with psoriasis, with or without arthritis, B27 and B7 are specifically associated with PsA. Associations with Class I alleles are stronger with HLA-B than HLA-C alleles. The association of HLA-C with PsA was found to be due to association with early onset psoriasis, since no association was found in patients with PsA and late onset psoriasis.
Another high-priority candidate is the TNF- gene, which is located 250 kb centromeric from the HLA-B locus. TNF- is a key inflammatory cytokine in psoriasis and PsA and is found in high levels in the serum, synovial fluid, and synovial membrane of patients with PsA. Associations have been reported between the TNF-308 polymorphism in the promoter region of the TNF- gene and PsA. The TNF308 polymorphism has been associated with the presence of joint erosions, progression of joint damage, and early age of the onset of PsA.
Subsequent studies have also confirmed an association between TNF-238 and -857 polymorphism and PsA.
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Physical Exam And Medical History Remain The Primary Tools
A review of your medical history would also be conducted to assess your symptoms and to rule out any other explanations for your condition. Less commonly, a tissue sample may be obtained to examine skin cells from the affected area with a microscopic.
Unlike some autoimmune disorders, there are no blood tests or imaging studies that can aid in the diagnosis of psoriasis.
Determining Your Next Step
If the pathology report determines that you have cancer or any other serious disease, you may want to get a second opinion. To do this, youll need to make sure that the second doctor gets the microscope slides and other related material from the pathologist.
Once its clear what youre dealing with, you and your doctor should discuss your treatment options. If the diagnosis is cancer, more tests will be needed to determine how far the disease may have spread. More procedures may also be needed to remove any more cancerous cells from your skin.
If you have psoriasis, a variety of treatment options are possible. These include topical lotions to reduce symptoms, or light therapy, which uses ultraviolet light to help heal damaged skin.
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Why Do I Need Blood Tests And What Are They
Blood tests are for screening purposes. We will check the fats in your blood , sugar , vitamin D level, liver function tests and kidney function tests together with a full blood count which checks you are not anaemic. We also screen for hepatitis B and C, HIV and whether youve had chicken pox, just in case we start you on a tablet form of medication.
Symptoms Of Psoriasis Are Known To Come And Go
Symptoms of psoriasis come and go, periodically improving and worsening. Sometimes psoriasis may clear for years and stay in remission. Often people have worsening of their symptoms in the colder winter months. Many people report improvement of the skin in warmer months, warmer climates, or with increased sunlight exposure.
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Blood Tests For Psoriatic Arthritis
Blood tests in themselves will not confirm a PsA diagnosis. These tests are usually given to determine the presence of inflammation and to rule out other conditions.
Read on to learn what types of blood tests may be given to make a PsA diagnosis.
- Erythrocyte sedimentation rate . This gauges your bodys degree of inflammation, though not specifically for PsA. It measures the amount of red blood cells that settle in a vial of blood, which is greater when you have inflammation.
- C-Reactive protein . Your doctor may order this test to check for an elevated C-reactive protein level. This test is not specific for PsA, but it does indicate the presence of inflammation.
- Rheumatoid Factor . Presence of this antibody in your blood indicates rheumatoid arthritis . Its presence means you dont have PsA.
- Anti-Cyclic Citrullinated Peptide test. These antibodies usually indicate RA. However, their presence can occur in other forms of arthritis, and your doctor will probably test for them.
- Human leukocyte antigen B27 . This is a protein found on the surface of white blood cells in some people with PsA.
- Serum uric acid. Your doctor may take a sample of fluid from your joints to check for uric acid crystals. Elevated uric acid in the blood or crystals in bodily fluids indicate gout.
Caspar Criteria For Diagnosis
Diagnosing psoriatic arthritis relies on markers in an established system called the Classification Criteria for Psoriatic Arthritis .
The criteria are each assigned a point value. Each one has a value of 1 point except for current psoriasis, which has a value of 2 points.
The criteria are as follows:
- current psoriasis outbreak
- personal or family history of psoriasis
- swollen fingers or toes, known as dactylitis
- nail problems, like separation from the nail bed
- bone growths near a joint that are visible on an X-ray
- absence of rheumatoid factor
A person must have at least 3 points based on the CASPAR criteria to be diagnosed with psoriatic arthritis.
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How Can You Identify Psoriasis On Your Skin
Psoriasis appears as red, flaky, raised skin.
To diagnose psoriasis, youll want to see a dermatologist, who will evaluate and possibly biopsy the skin to confirm the condition. But while its always wise to see a doctor when there are changes to your skin, you may not run to your dermatologist every time you experience flaky or red skin. To help you determine whether your skin irritation could be psoriasis, and therefore should be treated by a doctor, you can look for certain characteristics and take inventory of your routine.
Psoriasis most commonly appears as plaque, or raised red patches with white or silver-looking scales, around the knees, elbows, and scalp. The patches of irritated skin may burn or feel tender or thick to the touch. Youll also want to take note of any pain, stiffness, or swelling in the joints, as about one in three people with plaque psoriasis also develop psoriatic arthritis, according to the National Psoriasis Foundation.
Skin irritation, psoriasis included, can come as a result of a change in routine, such exposing the skin to new products . If this happens, first try getting back to the basics and only using gentle, fragrance-free products on the skin. If it gets better, you may have only experienced a mild skin irritation. If it gets worse or doesnt go away, it could be a sign of a psoriasis flare and youll want to see a doctor for treatment.
How Is Psoriasis Diagnosed And Treated
Psoriasis often has a typical appearance that a primary care doctor can recognize, but it can be confused with other skin diseases , so a dermatologist is often the best doctor to diagnose it. The treatment of psoriasis usually depends on how much skin is affected, how bad the disease is , or the location . Treatments range from creams and ointments applied to the affected areas to ultraviolet light therapy to drugs . Many people who have psoriasis also have serious health conditions such as diabetes, heart disease, and depression. Some people with psoriasis also have an inflammatory condition which affects their joints, called psoriatic arthritis.
Psoriatic arthritis has many of the same symptoms as other types of arthritis, so a rheumatologist is often the best doctor to diagnose it. The treatment of psoriatic arthritis usually involves the use of drugs .
Psoriatic disease may be treated with drugs or a combination of drugs and creams or ointments.
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What Causes Psoriasis
Psoriasis is an immune system problem. Your immune response overreacts, causing inflammation, which leads to new skin cells growing too fast.
Typically, new skin cells grow every 28 to 30 days. But in people with psoriasis, new cells grow and move to the skin surface every three to four days. The buildup of new cells replacing old cells creates the silvery scales of psoriasis.
Psoriasis runs in families. There may be a genetic component. Parents may pass it down to their children.
How To Stay Safe
Having psoriasis and a compromised immune system is a good reason to want to stay healthy.
To minimize your risk for COVID-19, take the following CDC precautions:
- Stay home as much as you can.
- Avoid crowds, and limit close contact with others when out in public.
- Avoid touching your face, nose, and mouth when out.
- Avoid touching frequently touched surfacessuch as doorknobs and shopping cartswhen out in public. Carry disinfecting wipes for when you need to touch surfaces.
- Wear a mask when in a crowded place.
- Talk to your doctor about whether the COVID vaccine is an option for you, and if it is, get vaccinated as soon as you can.
- Wash your hands with soap and water for at least 20 seconds or use hand sanitizer after coming inside or after touching commonly touched surfaces.
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What Are The Types Of Psoriasis
In children, common types of psoriasis include:
Plaque psoriasis. This is the most common type of psoriasis. It causes plaques and silvery scales, usually on the knees, elbows, lower back, and scalp. They can be itchy and painful and may crack and bleed.
Guttate psoriasis. This type often shows up after an illness, especially strep throat. It causes small red spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp, and ears.
Inverse psoriasis. This causes smooth, raw-looking patches of red skin that feel sore. The patches develop in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals, or under a woman’s breasts.
What Does A Fasting Blood Test Mean
We would like, if possible, that you do not eat before having your blood test taken as we will be checking the fats in your blood and glucose level. These can be artificially elevated if you have eaten recently. Fasting entails not eating or drinking anything except water, black tea or black coffee for nine hours before you have your blood test. Most people do this overnight and have their blood taken first thing in the morning.
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How Is Psoriasis Diagnosed
Doctors usually diagnose psoriasis by examining the skin, scalp, and nails. They’ll also ask whether someone else in the family has psoriasis and if the child recently had an illness or started taking a new medicine.
Rarely, doctors might take a skin sample to check more closely. A biopsy can tell the doctor whether it’s psoriasis or another condition with similar symptoms.