They are both inflammatory diseases, particularly affecting the small joints of the hands and feet: the pain they cause, sometimes accompanied by swelling and stiffness, especially in the morning, tends to decrease during the day and with movement. But aside from these similarities between psoriasis arthritis e rheumatoid arthritis there are important differences. According to the National Psoriasis Foundation, psoriatic arthritis affects up to 30% of people who have psoriasis and can also involve large joints. In some cases it can occur even before or even in the absence of the cutaneous form. Rheumatoid arthritis, on the other hand, is characterized by joint pains that are accompanied by some line of fever. This is what is reported in an article published by Aleati per la Salute (www.alleatiperlasalute.it), the portal dedicated to medical-scientific information created by Novartis.
The diagnosis of the two diseases is carried out during the rheumatological examination and, in the case of psoriatic arthritis, also dermatological. In addition to joint ultrasound and magnetic resonance imaging required together with some blood tests, especially useful in rheumatoid arthritis, palpation and observation of the joints are fundamental. A rheumatologist is in fact able to distinguish psoriatic arthritis from rheumatoid arthritis even if the former does not manifest itself with the typical lesions of the skin. In both disorders, symptoms can break out and worsen, linger for a while, and then temporarily go away.
In the case of rheumatoid arthritis – reads in depth – signs of inflammation are usually symmetrical, that is, they affect the joints on both sides of the body: not a wrist, but the wrists. In reverse, psoriatic arthritis is generally asymmetrical, so it can cause pain only in the left knee or right wrist. However, it is not possible to base the difference on this aspect alone because psoriatic arthritis can also give symmetrical symptoms.
Among other differences – points out the focus of Allies for Health – while in rheumatoid arthritis inflammation remains confined only to the joints, in patients with psoriatic arthritis there is involvement of the tendons. A typical symptom of psoriasis is enthesitis, a form of inflammation that affects the points where ligaments and tendons enter the bone. This condition can manifest itself with tennis elbow, plantar fasciitis, or heelitis. In addition, dactylitis (fingers take a “sausage” shape) and back pain associated with morning stiffness are common in patients with psoriatic arthritis.
Furthermore, psoriatic arthritis, if it has skin manifestations, can also affect the nails and be associated with psoriatic onychopathy. Psoriatic arthritis can also cause inflammation of the eye (uveitis or iritis).
In addition to increasing the risk of fractures and sprains, the two diseases cause chronic inflammation in the joints with an important functional limitation, but also at the level of internal organs, as in the case of psoriatic arthritis, which could be associated with cardiovascular or metabolic complications. Inflammation can also lead to osteoporosis or bone weakness.
Knowing the differences between psoriatic arthritis and rheumatoid arthritis could help you understand the different treatment opportunities that include: non-steroidal anti-inflammatory drugs, corticosteroids, physiotherapy, immunosuppressants, disease-modifying antirheumatic agents, biologics (genetically engineered proteins made up of genes humans).
Undoubtedly the two pathologies require a multidisciplinary approach that can involve, in addition to the key figure of the rheumatologist, also the dermatologist (in psoriatic arthritis) and various other figures for the management of extra-articular manifestations. In fact, intestinal disorders similar to those produced by chronic intestinal inflammatory diseases (Crohn’s disease and ulcerative colitis), or uveitis or cardiovascular diseases are possible.
Early treatment can prevent bone erosion and other damage to joints and other organs. For this it would be advisable to intervene within 3-4 months from the first symptoms, however a timely diagnosis is rarely done because the initial symptoms are not such as to worry. The complete article is available on: https://www.alleatiperlasalute.it/diagnosi/differenze-tra-artrite-psoriasica-e-artritis-reumatoide