Is It Psoriatic Arthritis or Rheumatoid Arthritis?

By Diane T

3 min read

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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Psoriatic-Arthritis.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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willowing Member
I was told by one Dr that I had knee, ankle and hip pain because I was a woman. I was 22 then and I did not receive a diagnosis until I was 56. I feared RA, I had watched my cousin die of RA, her bones literally disintegrated and she died when her ribs dissolved enough that her chest collapsed. The Dr who gave me a preliminary diagnosis was able to give me comfort on that point since you can have a blood test to rule out RA and I did not have the RA factors, this Dr was a temporary Dr at the clinic I went to but she was able to give me a referral to the Rheumy who could and did help me for a couple of years, until I lost that insurance when my husband retired. Finding another rheumatologist took another six years because every single clinic wanted me to start over again with a diagnosis. Finally, when I had breast cancer, my oncologist was able to force through a referral for me. Currently, I am struggling to find a pain management plan that works for me and I am a steady '8' on the chronic pain scale, I yearn for the days I only had a bad day at a '5'.
1. Diane T Moderator & Contributor
 I can relate to how you feel. Pain is real and no one can measure how we feel. I hope you get some relief soon. We are here if you need us. Thank you, Diane T
2. Carrie Gibbens Member
 <inline-mention username="willowing" user-id="3273390"/> I'm so sorry you're going through such physical & emotional pain. It's so distressing when you have to fight for help. I've had psoriatic arthritis for over 35yrs, but only diagnosed some 24yrs ago. On my bad days, I try to find something good, to either do or watch, but to also be as comfortable as possible & easy to move when needed. I started painting, I'm rubbish but it takes my mind away from the pain. Don't get me wrong it's still there, but I'm not concentrating on it. I once had Humira self injecting, it worked well for a few years, then my body got used to it. There are so many medications for psoriatic arthritis & new ones coming out each year. If you aren't already with a good hospital arthritic consultant get your GP to refer you with urgency. I hope this year will be as easy as possible for you xx
bbthodges Member
Diane, I found your article very interesting and want to add to your confusion. I have been having eye problems being dry and my doctor referred me to a specialist. Today I say her and she did some not so pleasant procedures to determine if my ducts were blocked. I also told her about having a severe case of dry mouth and we discussed my psoriatic arthritis. She really feels that I have Sjogren's Syndrome. She suggested that I have my rheumatologist have blood tests done to see if I do. I came home and looked this up on my laptop. Please look it up on your own computer and you will really be surprised. I was amazed at what this really is. Having the PsA and Fibromyalgia and much more, it fascinated me that all of this could be in the mix. Wait until you see.