An autoimmune disease, psoriatic arthritis, is commonly denoted as a progression of psoriasis. It is an autoimmune disease, and its diagnosis is extremely challenging.
Challenges in Diagnosing Psoriatic Arthritis
Like most autoimmune diseases, psoriatic arthritis doesn’t have an established etiology. It affects nearly 10% of all people suffering from psoriasis, but there are no definite, diagnostic symptoms to identify it at an early stage. Diagnosis of psoriatic arthritis puts forth extreme variations. For instance, it is rarely seen among pregnant women suffering from psoriasis, but its occurrence cannot be ruled out. The early symptoms of psoriatic arthritis are a bit misleading.
Most psoriatic arthritis sufferers complain about pain/stiffness in their joints that is interpreted as a musculoskeletal condition. It is only when swelling around the joints increases and over-the-counter medications don’t work, that the presence of psoriatic arthritis is indicated. Psoriatic arthritis is often confused with medical conditions having similar symptoms, like rheumatoid arthritis or gout and age-related body pains.
Diagnosing Psoriatic Arthritis
Since there is no individual, definitive test that can help to diagnose psoriatic arthritis, the insight and expertise of the attending physician is most critical. However, the following tests help in diagnosing psoriatic arthritis to some extent:
Complaints about arthritic pains usually call for an x-ray evaluation. This cannot be very helpful if the psoriatic arthritis is in its early stages. However, when the disease has progressed, the bones appear to be whittled in a typical manner. These are often referred to as classical symptoms of erosive arthritis. MRI scans can also reveal the progressing inflammation among the joints. A bone density can also reveal destruction of bone tissue around the joints.
Erythrocyte Sedimentation Rate (ESR) tests often help to point towards an undiagnosed inflammation in the joints. This is particularly true when bones in the lower back and knees are inflamed due to psoriatic arthritis. If the test readings are elevated, some form of a deep-seated arthritic problem is indicated. This can direct the physician towards diagnosing psoriatic arthritis.
If any of the above tests indicate the likelihood of psoriatic arthritis, further testing is pursued to rule-out possible conditions like gout. Gout patients have high, uric acid levels in their bone fluid so uric acid tests are conducted. Genetic marker testing called HLA-B27 Testing often helps to identify cases of spinal psoriatic arthritis.