Symptoms Of Psoriatic Arthritis
The severity of the condition can vary considerably from person to person. Some people may have severe problems affecting many joints, whereas others may only notice mild symptoms in 1 or 2 joints.
There may be times when your symptoms improve and periods when they get worse .
Relapses can be very difficult to predict, but can often be managed with medicine when they do occur.
The Connection Between Age And Arthritis
It’s one of the biggest misconceptions about arthritis. Most people believe that arthritis is an old person’s disease and that it is entirely a consequence of aging. If that were the case, arthritis would be inevitable and it’s not.
According to the Centers for Disease Control and Prevention , arthritis is more common among adults aged 65 years or older, but people of all ages can be affected. “Nearly two-thirds of people with arthritis are younger than 65. Arthritis is more common among women than men in every age group, and it affects members of all racial and ethnic groups. Arthritis is also more common among adults who are obese than among those who are normal weight or underweight.”
Finding A Specialist Can Be Difficult
A board-certified pediatric rheumatologist is specifically trained to diagnose and treat arthritis in children. But there are fewer than 400 U.S. doctors who specialize in the area, according to the Arthritis Foundation so parents may have to travel a distance with their child for an appointment with a specialist.
Additionally, if the child has skin and nail involvement with psoriasis, their treatment team will likely include a dermatologist.
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Who Is At Risk For Psoriatic Arthritis
Psoriasis affects 2-3 percent of the population or approximately 7 million people in the U.S. and up to 30% of these people can develop psoriatic arthritis. Psoriatic arthritis occurs most commonly in adults between the ages of 35 and 55 however, it can develop at any age. Psoriatic arthritis affects men and women equally.
It is possible to develop psoriatic arthritis with only a family history of psoriasis and while less common, psoriatic arthritis can occur before psoriasis appears. Children of parents with psoriasis are three times more likely to have psoriasis and are at greater risk for developing psoriatic arthritis. The most typical age of juvenile onset is 9-11 years of age.
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Key Points About Psoriatic Arthritis
- Psoriatic arthritis is a form of arthritis with a skin rash.
- Psoriasis is a chronic skin and nail disease. It causes red, scaly rashes and thick, pitted fingernails. The rash may come before or after the arthritis symptoms.
- Psoriatic arthritis causes inflamed, swollen, and painful joints. It happens most often in the fingers and toes. It can lead to deformed joints.
- Treatment may include medicines, heat and cold, splints, exercise, physical therapy, and surgery.
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How Is Psoriatic Arthritis Diagnosed
Psoriatic arthritis is easier to confirm if you already have psoriasis. If you donthave the skin symptoms, diagnosis is more difficult. The process starts with a healthhistory and a physical exam. Your healthcare provider will ask about your symptoms. Youmay have blood tests to check the following:
- Erythrocyte sedimentation rate . This test looks at how quickly red blood cells fall to the bottom of a test tube. When swelling and inflammation are present, the bloods proteins clump together and become heavier than normal. They fall and settle faster at the bottom of the test tube. The faster the blood cells fall, the more severe the inflammation.
- Uric acid. High blood uric acid levels can be seen in psoriatic arthritis but are not used for diagnosis or monitoring.
- Imaging. X-rays, CT scans, ultrasound, MRI, and skin biopsies may all be used to help diagnosis.
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.
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You May Find It Challenging To Manage Symptoms Of Psoriatic Arthritis
Unlike older adults, people in their twenties typically dont have any experience managing a chronic condition.
In general, its a little bit more challenging for young adults to recognize the importance of following up with a physician routinely, says Snyder. This may be the first time they’ve had to seek out medical attention on their own and be responsible for making and keeping appointments. Theyre busy and doing a lot of other things, and this is one more task to complete.
Staying on top of everyday self-care can also be a challenge, especially when your peers are living a more worry-free life, notes Meleney, who found that psoriatic arthritis and college life didnt always mesh well.
College was going out to bars, parties, or staying up all night watching movies or studying for an exam, she explains. That was an issue for me because sleep is so important for me in managing the pain and discomfort of psoriatic arthritis.
Senior Week, a string of parties that took place between the end of classes and graduation, had Meleney concerned from the get-go. I looked at my boyfriend and said, Were going to have to plan this week because Im going to have to figure out whats important to me and whats not, she remembers.
At midnight everyone decided to head out to a bar, but Meleney had hit the wall. It was hard for me to be like, Sorry guys, my joints are bad, and I cant go out tonight, but thats what I had to do, she explains.
I Feel At A Loss Sometimes Depressed Is This Normal
Yes, this is a very normal process, a form of mourning and coming to terms with the fact that you have arthritis, and some things may have to change in your lifestyle to compensate, making things easier for you. Dont panic, try to work through your feelings, talking with a partner or someone close to you, If the feelings don’t pass, see your doctor who may be able to refer you to some form of short-term counselling.
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Will Drug Treatments For Psoriatic Arthritis Make My Psoriasis Worse
Some drug treatments may make psoriasis worse, but then again, some can also make it better too. Before you start any treatments offered, discuss this both with your dermatologist and rheumatologist. DONT FORGET to politely request that both consultants let each other know of your treatment regimes, this helps both of them evaluate your treatment and any side effects that you may be likely to experience. Some people find that when their psoriasis is bad their arthritis is also bad and as one improves, so does the other. This most often occurs when the skin and joint disease start simultaneously. Some of the arthritis treatments also help the skin and this is can help the doctors decide which is the best drug to use.
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.
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How Old Do You Have To Be To Have Hip Pain
Hip pain in older children may also include some of the causes of hip pain in adults. Legg-Calvé-Perthes disease, sometimes called just Perthes disease, typically occurs in children between the ages of four and eight years old and is more common in boys, especially those who are very active and who are short for their age.
Rheumatoid Arthritis Age Of Onset
Rheumatoid arthritis is a progressive, autoimmune disease that affects several joints in the body. The disease is caused by the immune system attacking itself, targeting tissue primarily around joints.
RA is the most common form of arthritis, with the first symptoms most commonly being joint stiffness and swelling of the hands, feet, knees, or wrists. Women are three times more likely to develop RA, and across all demographics, it can start as early as 30 years old.
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Does The Severity Of Skin Or Nail Psoriasis Matter
- Nail changes are found in 2 out of 5 individuals with psoriatic arthritis, compared with around half in those with psoriasis alone.
- Nail changes include pitting and discolouration of the nail due to abnormalities in the growth of tissue in the nailbed.
- The risk of developing psoriatic arthritis is greater in individuals with severe psoriasis, yet severe psoriatic arthritis may occur with minimal skin disease.
How Will Psoriatic Arthritis Affect Me
Starting the right treatment as soon as possible will give you the best chance of keeping your arthritis under control and minimise damage to your body.
Psoriatic arthritis can vary a great deal between different people. This makes it difficult to offer advice on what you should expect.
It will usually have some effect on your ability to get around and your quality of life, but treatment will reduce the effect it has.
Psoriatic arthritis can cause long-term damage to joints, bones and other tissues in the body, especially if it isnt treated.
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You May Have Questions About Disease Severity
Being diagnosed with psoriatic arthritis in your twenties doesnt mean that the course of your disease will be more severe, according to Snyder.
In general, when we look at patients who have psoriatic arthritis, earlier onset does tend to suggest that their disease may be more aggressive, and their joints may take on more damage over time. Thats just based on the fact that theyve had the disease for longer than someone who develops it later, Snyder explains.
The good news is that there is a growing array of effective psoriatic arthritis therapies to help people manage the disease and prevent or limit the extensive joint damage that can occur without medical intervention. A big thing we focus on with our patients at any stage, but certainly our young patients, is preventing the progression of their disease, explains Snyder. We are much better at that now than we were even 15 or 20 years ago. There are really good therapies available now.
In fact, many patients who develop disease early in their life respond very well to therapy. These people are able to do most of the things they want to do without much joint pain or destruction of the joint, she explains.
Living With Psoriatic Arthritis
There is no cure for psoriatic arthritis. But you can reduce your symptoms by stickingto your treatment plan. Manage pain with medicine, acupuncture, and meditation. Getenough exercise. Good exercises include yoga, swimming, walking, and bicycling. Workwith a physical or occupational therapist. He or she can suggest devices to help you withyour daily tasks.
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How Can I Help My Child Live With Psoriatic Arthritis
Help your child manage his or her symptoms by sticking to the treatment plan. This includes getting enough sleep. Encourage exercise and physical therapy and find ways to make it fun. Work with your childâs school to make sure your child has help as needed. Work with other caregivers to help your child take part as much possible in school, social, and physical activities. Your child may also qualify for special help under Section 504 of the Rehabilitation Act of 1973. You can also help your child find a support group to be around with other children with pediatric arthritis.
What Is Psoriatic Arthritis
Psoriatic arthritis is a type of arthritis linked with psoriasis, a chronic skin andnail disease. Psoriasis causes red, scaly rashes and thick, pitted fingernails.Psoriatic arthritis is similar to rheumatoid arthritis in symptoms and jointswelling . But it tends to affect fewer joints than RA. And it does notmake the typical RA antibodies. The arthritis of psoriatic arthritis comes in 5forms:
- Arthritis that affects the small joints in the fingers, toes, or both
- Asymmetrical arthritis of the joints in the hands and feet
- Symmetrical polyarthritis, which is similar to RA
- Arthritis mutilans, a rare type of arthritis that destroys and deforms joints
- Psoriatic spondylitis, arthritis of the lower back and the spine
Psoriasis and Psoriasis Arthritis FAQ
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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.
When Psoriatic Arthritis Strikes At A Young Age
Children can show signs of the disease at a very young age, and managing the symptoms early on is critical.
Psoriatic arthritis is most common in adults between ages 30 and 50, but it can strike the very young. Early diagnosis and proper treatment are key to manage the diseases symptoms and prevent joint damage.
Ive seen psoriatic arthritis in infants at one year of age. While its not the most common age, the incidence increases as children approach the teenage years, says Lisa Imundo, MD, a board-certified pediatric rheumatologist at the Columbia University Irving Medical Center in New York City.
Dr. Imundo says a common characteristic of PsA in children is a swelling of the fingers known as dactylitis, or sausage fingers.
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Work And Psoriatic Arthritis
Having psoriatic arthritis may make some aspects of working life more challenging. But, if youre on the right treatment, its certainly possible to continue working.
Help and support is available, and you have rights and options.
The Government scheme Access to Work is a grant that can pay for equipment to help you with activities such as answering the phone, going to meetings, and getting to and from work.
The 2010 Equality Act, and the Disability Discrimination Act in Northern Ireland makes it unlawful for employers to treat anyone with a disability less favourably than anyone else. Psoriatic arthritis can be classed as a disability if its making every-day tasks difficult.
Your employer may need to make adjustments to your working environment, so you can do your job comfortably and safely.
You might be able to change some aspects of your job or working arrangements, or train for a different role.
In order to get the support youre entitled to, youll need to tell your employer about your condition. Your manager or HR department might be a good place to start.
Other available support might include:
- your workplace occupational health department, if there is one
- an occupational therapist. You could be referred to one by your GP or you could see one privately
- disability employment advisors, or other staff, at your local JobCentre Plus
- a Citizens Advice bureau particularly if you feel youre not getting the support youre entitled to.
Are There Any New Drugs For Arthritis Of The Hip
Some types of arthritis may respond to new categories of drugs known as symptom-modifying antirheumatic drugs and disease-modifying antirheumatic drugs . These are powerful new drugs, which are not appropriate for everyone with arthritis. Devices such as canes or walkers to make it easier and safer for you to walk.
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How Can I Find The Appropriate Care I Need
Initially your GP is the first point of contact, who then should refer you on to a dermatologist/rheumatologist, if this is not already the case. If you are not happy with the advice you receive, remember you are always entitled to seek a second opinion. Remember, If you are seeing a dermatologists for your psoriasis and a rheumatologists for your arthritis make sure each is aware of this, so they can liaise and provide you with appropriate care for both conditons.
Psoriatic arthritis and rheumatoid arthritis are both autoimmune diseases that affect the joints. Both are inflammatory and progressivecausing joint stiffness, pain, and swelling, as well as persistent fatigue. In addition, both occur in flares and can be treated with medications that suppress the immune system.
However, PsA and RA are different diseasesand the differences are important when it comes to their prognosis and the best approach for managing each condition.
With PsA, the joint symptoms are tightly linked to inflammation of the skin from psoriasis . With RA, the immune system primarily targets joint tissue.
The different underlying disease processes mean that the conditions are diagnosed with different methods and they also require different therapeutic approaches.
Joint Pain Or Stiffness
Psoriatic arthritis causes inflammation in the joints, which can cause pain, tenderness, and stiffness. You might feel this in just one joint or in several.
Psoriatic arthritis usually affects the knees, fingers, toes, ankles, and lower back. Symptoms of pain and stiffness may disappear at times, and then return and worsen at other times. When symptoms subside for a time, its known as a remission. When they worsen, its called a flare-up.
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