Psoriatic arthritis: definition
Psoriatic arthritis is a chronic form of inflammatory arthritis, and is one of a group of spondyloarthropathies. It affects 0.1% to 1% of the population, with identical rates of incidence in men and women, and generally occurs between the ages of 30 and 50. It can affect the peripheral joints (in 70% of cases), but also the spinal column (axial form) or entheses (connective tissue).
Men suffer more frequently from axial joints, and women experience problems with limb joints more frequently than men.
In 64% to 87% of cases, psoriatic arthritis is preceded by a skin problem. The reverse is only observed in between 6% and 18% of cases. In 8% to 30% of cases, the two conditions are present simultaneously.
Psoriatic arthritis manifests in the form of joint pain at night and in the morning, and does not subside when at rest. Patients also experience stiffness in the morning and the progression of the illness is very slow, coming in the form of flare-ups.
Psoriatic arthritis can end up being highly debilitating in between 10% and 20% of cases. Damage to the joint structure is also seen.
A diagnosis of psoriatic arthritis is generally considered based on the description of the pain given by the patient, the presence of psoriasis on the skin as well as a clinical examination of the skin and the joints by a doctor.
The signs of inflammation are detected by testing a blood sample (elevated sedimentation rate and C-reactive protein). Testing for the antigen HLA B27 is an important criterion in the axial forms of the condition.
Finally, a radiological exam should reveal signs that point to psoriatic arthritis (distinguishing it from spondyloarthritis).
It is the combination of these different tests and exams by a rheumatologist that allows psoriatic arthritis to be diagnosed reliably and for certain.
Psoriatic arthritis: finding out more
There are various types of treatment for psoriatic arthritis: to treat the pain associated with inflammation, to fight stiffening, but also to limit the progression of the illness with background treatment.
As first-line treatment, painkillers, corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDS) can fight the pain, stiffness in the morning and joint mobility. They can be complemented by surgical procedures or interventions if some joints are still painful.
If these initial treatments are insufficient, anti-TNF alpha can be used as second-line treatment. The availability of biotherapies has made it possible to alleviate the progression of joint conditions and to improve the quality of life of patients affected by severe forms of psoriatic arthritis. These treatments are prescribed in hospital and are expensive. Ultimately, non-drug treatments such as functional rehabilitation or physiotherapy play an important role.
In the majority of cases, care for this disease involves many specialists, specifically rheumatologists, general practitioners, dermatologists, physiotherapists, occupational therapists and functional rehab specialists.
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