Woman considering two objects that are similar but also different representing PsA and RA

Is It Psoriatic Arthritis or Rheumatoid Arthritis?

I have had psoriatic arthritis for over 30 years now. It took a long time for me to get the proper diagnosis. There were times I felt like my doctor was playing a guessing game at what to diagnosis me with. At one point he thought it was rheumatoid arthritis.

Did you know that psoriatic arthritis and rheumatoid arthritis are both autoimmune diseases and can have very similar symptoms, but are not the same? These two conditions are often misdiagnosed, and it is important for us as patients to get the right care. They can both attack healthy parts of our body, specifically, joint tissue which can cause swelling, stiffness and lead to damage of other organs in your body.

How can you tell the difference?

People who suffer from RA; their immune system will attack the lining of the tissues around their joints. This causes swelling, inflammation and it becomes very painful. This can lead to deformation. People who suffer from PsA, their immune system attacks and damages their joints and their skin. It causes their body to make too many skin cells and this leads to psoriasis. Psoriasis is a skin condition that shows up in red splotches, flakes and scaly plaques. Some of us with psoriasis with develop PsA.

I spoke to a doctor who told me that psoriatic arthritis may be misdiagnosed as rheumatoid arthritis, but since the root cause is different, it should be treated differently. Up until around 2013, many doctors were treating patients with drugs designed to treat RA. We are fortunate enough to have our own treatments now that allows PsA patients to get the best treatment for our condition.

Challenges in diagnosing PsA versus RA

One thing is for sure, we need to get a timely diagnosis to prevent damage and improve our quality of life for us the patient. In PsA and RA patients joint damage can begin as early as 6 months after the first symptoms present themselves. Joint changes would include erosion and deterioration can happen very quickly, and this is risky for the patient because early treatment can prevent much of this from happening. The bad news is many patients have delays in receiving a proper diagnosis. Some patients can end up waiting 5 years before getting the proper diagnosis.  I waited for 25 years.

Patients with PsA specifically have trouble getting diagnosed and treated timely. This can make those living with psoriasis have an even tougher time if they develop PsA. Additionally, psoriatic arthritis sufferers run a higher chance of suffering from inflammatory bowel disease more popularly known as Crohn’s disease. Many studies have shown chronic inflammation underlies both inflammatory bowel disease and PsA. The problem with this is many of the medications used to treat arthritis or RA have shown to exacerbate IBD symptoms in PsA patients.

Therefore, it is crucial for patients to receive a timely and accurate diagnosis of their condition.

Similar symptoms between PsA and RA

Many of the symptoms can mimic each other, it is important for the patient to research and understand the difference. Sometimes without the presence of a psoriasis skin rash, a PsA patient will ultimately be told they have RA. An indicator of PsA are the sausage-like fingers that are swollen. In RA, patients will typically have joint pain equally on both sides of the body in the same area, mostly the wrists. PsA patients will tend to have joint pain closer to the nail bed, feet and lower back. Because of the additional high-risk factors that can be associated with PsA, doctors need to do their due diligence in diagnosing us right and a quicker response.  I had to go to several doctors before finding the right one. This is sad, but realistic because finding the right doctor who will listen is key to winning the overall battle.

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