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Arthritis Living with Arthritis

Managing Psoriatic Arthritis


Medically Reviewed On: January 17, 2007

Historically, psoriatic arthritis (PsA) has received inadequate attention from the medical community. Researchers believed the condition was a relatively mild form of arthritis, and as a result, it frequently went undiagnosed and untreated. Only recently has it become the subject of greater understanding.

Today, psoriatic arthritis is recognized as a chronic condition with profound, deleterious effects that are considered equal to those of other destructive immune system diseases, such as rheumatoid arthritis. A recent survey conducted by the National Psoriasis Foundation found that about one million Americans suffer from the disease, a number that is roughly double of what was previously thought.

Quality of Life Affected
Psoriatic arthritis occurs when a malfunctioning immune system causes inflammation that leads to painful swelling of the joints, hands and feet. Often, it strikes in the prime of adulthood, between the ages of 30 and 50, and it can have a serious impact on the overall quality of life. This was proven in a 2002 survey conducted by the National Psoriasis Foundation. Nearly 85 percent of the 27,000 people surveyed said that psoriatic arthritis has a moderate to significant impact on their daily activities. Three quarters of the people surveyed said they lose sleep or sleep poorly as a result of the disease, while 69 percent said the disease interferes with their educational, vocational and/or social activities.

Serious Consequences at Stake
Identifying psoriatic arthritis as soon as possible is important, because the resulting joint damage, or “joint progression,” often takes place in the early stages of the disease. However, the complications caused by the erosion and destruction of the joints, specifically, painful movement leading to a limited ability to function, may not appear until a much later date.

Unfortunately, the disease can be difficult to diagnose. Few tests exist to recognize its presence, and X-rays usually do not reveal the initial signs. Instead, doctors must rely on their clinical observations and learn to recognize the distinct characteristics of psoriatic arthritis in order to make an early diagnosis. Left untreated, the disease has the potential to cripple and disable.

In about 20 percent of people, psoriatic arthritis is deforming and destructive. The damage is caused by the persistent inflammation of the synovium, the thin membrane or connective tissue that lines the cavity of a joint and produces synovial fluid. It also results in enthesitis, an inflammation occurring at the point of attachment of the tendons, ligaments and connective tissue to a bone.

In some instances, the condition also leads to inflammation in bodily tissues, such as the tendons and cartilage, and in the eyes, heart, lungs and kidneys. On rare occasions, complications, such as joint dislocations of the neck and leaking of the heart valves, have been known to occur.

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