Frequently Asked Questions
Psoriatic Arthritis
| Q. If I have psoriasis of the skin, what are the chances that I will develop psoriatic arthritis? |
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A. Most studies would suggest that 10-15% of patients with psoriasis will go on to develop psoriatic arthritis. |
| Q. Is it true that my psoriasis might vary from season to season and that this would have some impact on my arthritis? |
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A. Involvement of the skin with psoriasis does improve with the ultra-violet light associated with sun exposure, therefore, you will tend to be better during the summer months. |
| Q. Is it true that my psoriatic arthritis will get worse if my skin gets worse? |
| A. There tends to be an association between flares of the skin and scalp with worsening of the joint symptoms, although this is not always the case. |
| Q. I understand that psoriatic arthritis may present in various ways. Could you please explain that to me? |
| A. Yes. Some patients develop psoriatic arthritis that resembles rheumatoid arthritis almost exactly, with symmetrical involvement of the middle joints of your fingers and near joints of the hands as well as involvement of the wrists. Examination of the joints alone might make it difficult to even distinguish between these two conditions, especially in the absence of any psoriasis of the skin (sometimes the arthritis of psoriatic arthritis may precede the skin involvement). Other patients may have predominantly involvement of the end joints of their fingers called the DIPs. The majority of patients tend to present with an asymmetric type arthritis which distinguishes it from rheumatoid arthritis with involvement of the end joints, middle joints and near joints of the fingers as well as the wrists. Some patients may also present with involvement of the spine and sacroiliac joints, once again in an asymmetric fashion, although this may occur later on in the course of their arthritis. There may be very destructive presentation of psoriatic arthritis, which fortunately only occurs rarely. This is called arthritis mutilans and may cause significant damage to the bones of the digits. |
| Q. If I am already being treated with a Non-Steroidal Anti-Inflammatory Drug (NSAID) for my psoriatic arthritis, how long should I wait before I should go onto other more aggressive treatments for my arthritis? |
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A. Rheumatologists are now starting Disease Modifying Anti-Rheumatic Drugs (DMARDs) much earlier than we were many years ago. This more aggressive approach is designed to control the arthritis much more rapidly and prevent erosive and destructive disease of the joints. Studies have now shown that by doing so, one can prevent deformities that would otherwise occur in the joints. In psoriatic arthritis we also have the additional problem of the tendency of the bone to fuse across the joint which also leads to significant loss of mobility and function. Early aggressive treatment may help prevent this from occurring. |
| Q. I was told by one doctor that I might have Reiter's syndrome. Another doctor has now diagnosed me with psoriatic arthritis. What is the difference? |
| A. Reiter's syndrome can mimic the joint findings that occur in psoriatic arthritis with the presence of redness and swelling of the end joints and middle joints of the fingers and toes including a diffuse swollen or sausage-shaped appearance to the digit. Reiter's syndrome not only presents with arthritis but may manifest itself with pus in the eye (conjunctivitis) and burning on urination with inflammation of the urethra (urethritis). |
| Q. Do injections of steroids in the joints help in psoriatic arthritis? |
| A. Yes. Cortisone injected in the joints helps in this condition just as it helps in rheumatoid arthritis when inflammation in the joint is present. |
| Q. Are injections of Synvisc approved for use in psoriatic arthritis in the knees? |
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A. No. Synvisc is only approved at the present time for injections of the knees in osteoarthritis and is not approved for use in inflammatory forms of arthritis such as psoriatic arthritis. |