Patients with psoriatic arthritis typically present with joint pain, swelling and morning stiffness. Patients may also have inflammatory low back pain, or back pain which improves, rather than worsens, with activity. Additionally, inflammation at the sites where tendons and ligaments attach to the bone is another key feature of psoriatic arthritis. This commonly occurs in the heel, foot, and hands.
Currently, there are no laboratory tests that are diagnostic of psoriatic arthritis. Patients with psoriatic arthritis typically test negative for rheumatoid arthritis and other autoimmune disorders. MRIs, which are more sensitive than x-rays, can be used to image an area of concern if x-rays are normal, but there is still a high level of suspicion for an underlying problem.
Mild arthritis symptoms can be managed with non-steroidal anti-inflammatories or local steroid injections into the affected joints. Moderate symptoms are treated with anti-rheumatic drugs but there are several newer oral medications that have been approved for treatment as well. Patients with severe disease are often treated with biologic agents, such as anti-tumor necrosis factor inhibitors.
Dr. Dee Dee Wu is a rheumatologist who specializes in the treatment of rheumatoid arthritis, psoriatic arthritis, osteoarthritis and osteoporosis. She practices at both the HSS Outpatient Center in Paramus and the hospital’s main campus in New York.