Why Im Interested In Rheumatoid Arthritis Swelling
About four years ago, my toe joints swelled to twice their normal size. Naïve to RA politics, I did not photograph them. Neither did my podiatrist.
After a few weeks, the swelling subsided. As I detail in my RA Onset Story, RA symptoms methodically spread to every joint in a neat symmetrical fashion. I was systematically disabled. Since then, I live with tremendous pain, stiffness, and disability. However, I never again saw that remarkable swelling I did at the beginning only minor puffiness.
Over a year ago, I began to research RA swelling because my rheumatology doctor was puzzled and frustrated. Is that funny? Why didnt the doctor do what I did? Oh well, on with our story.
Can Psoriatic Arthritis Attack Other Organs Of The Body
Apart from the skin, nails and joints, increased cardiovascular morbidity is considered part of psoriatic disease, as is the association with inflammatory bowel disease. An itchy, red eye due to conjunctivitis is more common in people with psoriatic arthritis and some people occasionally develop a painful, red eye caused by inflammation around the pupil of the eye, which is called iritis or uveitis. Anaemia may also be found but this is the result of long-term inflammation and is not a specific feature of psoriatic arthritis.
Loss Of Joint Function
Because rheumatoid arthritis leads to pain, swelling, and tenderness of the involved joints, there is the loss of joint function. The swelling and sensitivity impede the full motion and stability of the joint and it becomes incapable of carrying the movement with confidence, balance, and completeness. This loss of joint function leads to limping, lack of coordination, loss of grip and dexterity, and disability.
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Why Is Early Treatment Important
PsA can cause permanent joint damage when left untreated. The joints may become so damaged in severe cases that they no longer function. This is why recognizing it early is important for overall health.
Having PsA also
If you have PsA, its important to see your doctor for regular checkups. They can help monitor your weight and test you for conditions like high blood pressure or diabetes. Screenings can help you start treatment early if you develop any other conditions.
Here youll find some answers to additional questions about PsA and psoriasis.
Who Can Diagnose And Treat Psoriatic Arthritis
If you have painful, swollen joints and other symptoms, start with your primary care doctor, says Dr. Parody. They may refer you to a rheumatologist, who specializes in diagnosing and treating arthritis and other diseases that affect the joints, muscles and bones.
Some psoriatic arthritis treatments will also help calm skin symptoms. But if you have bothersome psoriasis symptoms, it can be helpful to see a dermatologist, too .
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I Have Psoriatic Arthritis But No Swelling Is That Possible
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How Is Psoriatic Arthritis Diagnosed
Unfortunately, no single test can identify psoriatic arthritis. Its usually easier for a doctor to diagnose you if you have psoriasis, as the two diseases often tag team.
Whether or not your skin is involved, your doctor will consider several factors to make a diagnosis. These include:
- Medical history.
- X-rays of affected joints.
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People With Psa May Not Have Psoriasis Or May Not *realize* They Have Psoriasis
In about 70 percent of PsA cases, psoriasis symptoms come first. In about another 15 percent, psoriasis and PsA symptoms strike at the same time and in another 15 percent, the arthritis-like symptoms come first.
When patients dont have obvious psoriasis symptoms, it can lead doctors to not suspect PsA, says Daytona Beach, Florida, rheumatologist and CreakyJoints medical advisor Vinicius Domingues, MD. Patients have zero skin manifestations, but they have an inflammatory pattern of pain, and then just because they dont have psoriasis, doctors dont diagnose them with psoriatic arthritis.
Or you may have psoriasis, but not realize or think about it much. Its not always easy to diagnose the psoriasis or see the psoriasis, Dr. Haberman notes. Patients think, Oh, Ive had this one little area behind my ear that sometimes itches, but otherwise they never notice it. Or they could have a little fleck in their scalp, which they just think is dandruff.
How Is Psa Diagnosed
Getting a PsA diagnosis can be tricky. More than half of people with PsA wait more than two years for a diagnosis, a study published in the Journal of Rheumatology found. Why the hold-up? Without a definitive test for PsA, its often misdiagnosed as another achy joint condition, such as rheumatoid arthritis. Getting a diagnosis involves:
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Clinical presentation
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Raised inflammatory markers in the blood
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A negative rheumatoid factor to rule out rheumatoid arthritis
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X-rays, MRI, or a CT scan to check for erosive damage to the bone
You want to have baseline radiology at the onset, Dr. Yun says. This is helpful in monitoring the progression of the condition.
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Prognosis Of Psoriatic Arthritis
Estimating prognosis in PsA is difficult due to a lack of evidence and significant individual variability. PsA can evolve over time with variable joint and extra-articular involvement, according to multiple investigations. The pattern of peripheral joint disease appears to evolve with time, with oligoarthritis being more common in early disease patients than late disease individuals. In majority of the cases, increasing disease duration leads to increased joint involvement, with a large proportion of individuals with monoarthritis or oligoarthritis progressing to polyarthritis. Axial involvement becomes more likely as the disease progresses.1
PsA is a disease that can cause severe morbidity and have a negative impact on patients quality of life. Some characteristics are thought to indicate a severe disease course and a poor prognosis. A high number of actively inflamed joints or polyarticular presentations, raised ESR, clinical or radiographical damage, loss of function and a lower quality of life are all indicators.11
Psoriatic Arthritis Signs And Symptoms
Early symptoms with psoriatic arthritis are important. People will complain of pain and swelling in their joints hands, feet, wrists, etc. They may have a small patch of psoriasis or have psoriasis covering many areas of the body. There may be complaints of stiffness and fatigue. For example, studies in Toronto showed the year before they were diagnosed, people had reported joint pain, fatigue, and stiffness. Early in the disease, people will often have episodes of worsening of the psoriatic arthritis and then episodes of improvement.
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Whats My Next Step If I Suspect Psa
PsA tends to show up after PsO makes an appearancesometimes as much as a decade later. But because the symptoms overlap with other joint conditions, can be challenging. However, knowing you have risk factors and recognizing the symptoms can help get you diagnosed fasterand stave off joint damage. If this sounds like you, and you have signs of PsA, bring up your concerns with your doctor.
Arthritis Related To Inflammatory Bowel Disease
Arthritis can also be a co-occurring disease in inflammatory bowel diseases like Crohns disease and ulcerative colitis. This kind of arthritis, also a type of spondyloarthritis, is called enteropathic arthritis. The pattern of symptoms can be very similar to that of PsA, including asymmetric joint pain and lower back pain. Psoriasis can also co-occur in people with inflammatory bowel disease, which makes separating PsA from IBD-related arthritis even more confusing.
But usually people with IBD-related arthritis do not have the nail changes characteristic of PsA. The distal joints of the fingers the ones closest to the fingernails also tend to not be affected in IBD-related arthritis.
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Can Psoriatic Arthritis Affect Children Too
As many as 12,000 children in the UK are affected by arthritis. It is known as juvenile chronic arthritis , of which there are three main types, stills disease, polyarticular juvenile chronic arthritis and polyarticular onset juvenile chronic arthritis. Psoriatic arthritis is a minor subset of JCA and is uncommon.
Occurrence In The United States
According to the National Psoriasis Foundation, psoriatic arthritis affects about 1 million people in the United States, or about 30% of all persons with psoriasis. However, prevalence rates vary widely among studies. In one population-based study, less than 10% of patients with psoriasis developed clinically recognized psoriatic arthritis during a 30-year period. A random telephone survey of 27,220 US residents found a 0.25% prevalence rate for psoriatic arthritis in the general population and an 11% prevalence rate in patients with psoriasis. However, the exact frequency of the disorder in patients with psoriasis remains uncertain, with the estimated rate ranging from 5-30%.
Moreover, since the late 20th century, the incidence of psoriatic arthritis appears to have been rising in both men and women. Reasons for the increase are unknown it may be related to a true change in incidence or to a greater overall awareness of the diagnosis by physicians.
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Focusing On People With Psoriasis
Most people with psoriatic arthritis have psoriasis first. For a small percentage of patients, psoriatic arthritis occurs before psoriasis, although most often they will have a first-degree relative with skin psoriasis, notes Dr. Haberman. Still, others have no skin psoriasis or dont notice the psoriasis hidden in areas like the scalp, umbilicus, and gluteal fold.
Read more about the connection between psoriasis and PsA.
Up to 30 percent of patients with psoriasis will go on to develop psoriatic arthritis, says Dr. Haberman. The majority of cases begin with the skin condition and then progress to joint pain within seven to 10 years. Recent studies have found that patients with psoriasis who develop severe fatigue, heel pain, and joint pain without overt swelling are more likely to develop PsA.
While we dont yet know which individual patients with psoriasis will go onto develop PsA, researchers have identified a few potential risk factors for the progression of PsA, including:
- Family history of psoriatic arthritis
- Psoriasis that affects the scalp and groin
- Nail involvement in psoriasis, such as nail pitting
- Being overweight or obese. PsA is worse in patients who are overweight and often biologics may not work as effectively in people who are overweight, says Dr. Haberman.
- Exposure to certain infections
- Physical trauma
Symptoms That Affect Your Skin
Some people with RA get rheumatoid nodules. These are bumps under the skin. Most of the time, they arenât painful, and they move easily when you touch them. About one in four people with RA get these skin bumps.
They usually happen on your elbows, but they might show up on other bony areas like:
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Psoriatic Arthritis Without Joint Swellings
Posted Sun 21 Jan 2018 11.15 by Paul macbayHi. I’m Paul and I have had guttate & plaque psoriasis from the age of 4 and recently PSA which first started in my teens but was missed.
Posted Sun 21 Jan 2018 15.49 by thin-skinnedIrascible septuagenarian fed up with the psoriasis constantly at me 😉
1Posted Sun 21 Jan 2018 20.31 by living with psoriasis
Ra Progression: What Are The Signs Of Rheumatoid Arthritis Progression
If you suspect you have rheumatoid arthritis or have been recently diagnosed with RA, you will likely have lots of questions and be feeling uncertain about what this disease means for your future. What is the normal RA progression? Will my symptoms get worse? How can I manage the disease? Do I have to have a surgery?
These are all frequent questions asked by RA sufferers. The reality though is that each patient will experience a unique progression of this disease. RA progression depends on multiple unpredictable variables. Because it is still unclear exactly what triggers RA, it can be nearly impossible to predict an exact outcome.
Below is some general information about what to expect as well as the different stages of RA including the advanced condition known as progressive rheumatoid arthritis.
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Treatments For Your Skin
If your psoriasis is affecting your quality of life, or your treatment is not working, you may be referred to a dermatologist.
There are a number of treatment options for psoriasis.
Ointments, creams, and gels that can be applied to the skin include:
- ointments made from a medicine called dithranol
- steroid-based creams and lotions
- vitamin D-like ointments such ascalcipotriol and tacalcitol
- vitamin A-like gels such astazarotene
- tar-based ointments.
For more information about the benefits and disadvantages of any of these talk to your GP, dermatologist, or pharmacist.
If the creams and ointments dont help, your doctor may suggest light therapy, also known as phototherapy. This involves being exposed to short spells of strong ultraviolet light in hospital.
Once this treatment has started, youll need to have it regularly and stick to the appointments youve been given, for it to be successful. This treatment is not suitable for people at high risk of skin cancer or for children. For some people, this treatment can make their psoriasis worse.
Retinoid tablets, such as acitretin, are made from substances related to vitamin A. These can be useful if your psoriasis isnt responding to other treatments. However, they can cause dry skin and you may not be able to take them if you have diabetes.
Some DMARDs used for psoriatic arthritis will also help with psoriasis.
Comorbidities Of Psoriatic Arthritis
PsA is linked to a number of chronic illnesses that can shorten life and reduce the quality of life. Even though most studies suggest that overall mortality in individuals with psoriatic arthritis is not greater than in the general population, obesity and cardiovascular comorbid conditions are more common, which might affect lifespan and quality of life.
When compared to the general population, the prevalence of cardiovascular risk factors such as hypertension, hyperlipidemia, type 2 diabetes mellitus, and the combination of these is higher in psoriatic arthritis. Even after adjusting for established risk variables, psoriatic arthritis is linked to an elevated risk of cardiovascular events like myocardial infarction. Similarly, people with psoriatic arthritis have a higher chance of developing type 2 diabetes and fatty liver.1
PsA has also been linked to extra-articular symptoms such as uveitis and inflammatory bowel disease, such as Crohns disease and ulcerative colitis. In patients with psoriatic arthritis, a meta-analysis found a 3% prevalence of uveitis and a 3% prevalence of inflammatory bowel disease. Because not all psoriatic arthritis treatments cover various manifestations, these conditions can have a significant impact on treatment choices.1
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Favorite Orgs For Essential Rheumatoid Arthritis Information
The American College of Rheumatology is an organization for physicians, health professionals, and scientists that advances rheumatology through education, research, advocacy, and practice support relating to the care of people with arthritis and rheumatic and musculoskeletal diseases. It publishes two medical journals and promotes research into rheumatological conditions.
The Arthritis Foundation is a nonprofit organization dedicated to the prevention, control, and cure of arthritis. The foundation provides information and resources, access to optimal care, advancements in science, and community networking.
CreakyJoints is a leading support, education, advocacy, and research organization for people living with arthritis and rheumatic disease. It is dedicated to raising awareness of all forms of arthritis, which includes educating people about the available varieties of treatment and management strategies.
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Loss Of Significant Joint Mobility
For example, you were able to flex your wrist 60 degrees, and two years later, you lost 50 percent of that range of motion. Its possible to feel okay and still experience loss of range of motion, says Dr. Domingues. But the idea is to prevent joint damage and to make you have less pain. If you have less pain and are still progressing, that means your treatment could be working better.
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Warning Signs Of Psoriatic Arthritis
Psoriatic arthritis is a type of arthritis that affects 30% of people with psoriasis, according to the National Psoriasis Foundation. With PsA, your immune system attacks your own body, especially the skin and joints. PsA can mimic other forms of arthritis, such as gout, rheumatoid arthritis and osteoarthritis, says Dr. H. Kevin Jones, FAAOS,, a board-certified orthopedic surgeon at Beaufort Memorial Orthopaedic Specialists. Blood tests can point to other similar conditions and check for signs of inflammation. We can also order X-rays to look for bone and joint changes.
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How To Better Manage Psoriatic Arthritis Right Now
One unique symptom of psoriatic arthritis that doctors look for is the presence of psoriasis, a condition that causes thick, discolored, scaly skin patches known as plaques, as well as pitted nails or nails that separate from the nail bed, according to the American Academy of Dermatology.
Like psoriatic arthritis, psoriasis stems from a faulty immune response, in which the immune system mistakenly attacks healthy cells and tissues.
About a third of people with psoriasis develop psoriatic arthritis, according to the Arthritis Foundation. About 10 percent of people develop arthritis first, then psoriasis later, says Eric Ruderman, MD, a rheumatologist at Northwestern Memorial Hospital in Chicago.
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