Diagnosis and Treatment of Psoriatic Arthritis

The diagnosis is mainly clinical, because analytics is nonspecific and alters only in severe cases. Synovial fluid analysis, although it is inflammatory, also is nonspecific.

Radiology is normal, at least until the process is well advanced, when signs such as:

  • There may be a hallmark, called a "pencil in cup" in the distal interphalangeal joints (proximal narrowing and widening distal).
  • Bony ankylosis, especially in the fingers.
  • Juxtaarticular Osteoporosis is less evident than in rheumatoid arthritis.
  • The condition of the spine is more frequent than in other pathologies, but differs in that it is asymmetric. Also, sometimes appear syndesmophytes, but also differ from other types of arthritis and usually affect only 2 or 3 vertebrae begins in the cervical region and is not progressive.

There are a number of medications that can be used in psoriasis and psoriatic arthritis. Choosing the drug is related to disease type, age, the skin involvement, etc. your rheumatologist will tell you all that apply to your case.

There are situations where the disease is moderate and may be enough the use of anti-inflammatories without steroids.

Regarding the treatment of skin lesions is the same as any psoriasis.

For joint symptoms are recommended:

  • General measures such as physiotherapy and postural ejericicios, which aims to:
  • Encourage the extensor muscles of the back.
  • Maintain the functionality of large joints, most important to everyday life.
  • Sleep on hard mattress with thin or no pillow can be helpful.
  • NSAIDs and coxibs.
  • The so-called disease-modifying drugs (DMARDs) such as methotrexate and salazoprina are indicated in ankylosing spondylitis, especially if peripheral.
  • You can also try with retinoids and cyclosporin A, and anti-TNF biologic therapy (Infliximab). Biological therapy involves the use of inhibitors of tumor necrosis factor (TNF). TNF is a cytokine involved in natural inflammatory and immune responses normal. Have shown that different studies4 Adalimumab, the first fully human monoclonal antibody produced by recombinant DNA technology, enables the reduction of signs and symptoms of active arthritis in patients with psoriatic arthritis, whether given alone or in combination with ARM agents. Adalimumab binds specifically to TNF (tumor necrosis factor) but not to lymphotoxin (TNF-beta) and neutralizes the biological function of this by blocking its interaction with the p55 and p75 for TNF in the cell surface.