Diagnostic Imaging of My Psoriatic Arthritis

By Diane T

3 min read

What are you really seeing?

Psoriatic arthritis is an inflammatory disease. I had to go through x-rays, MRI’s, and ultrasounds to get the proper diagnosis. As a patient, I know firsthand the difficulty in getting that correct diagnosis. It took them 25 years to get my diagnosis right.

Psoriatic arthritis is one of the spondyloarthritides. It affects the peripheral joints, axial joints, and spine. There are known 78 major joints in the body. Psoriatic arthritis is no respecter of persons. It can come in and wreak havoc on any of these joints. Usually, it affects the fingers and toes. It is known to affect the knees and ankles. The most popular description would be the sausage-like swelling of that joint. This is called dactylitis. This is what I have.

Diagnosing PsA: Step by step

Let’s begin this journey of what the rheumatologist are looking for. I will go step by step in a routine psoriatic arthritis diagnostic. This is some of my journey.

The first thing I had to do was make an appointment with a rheumatologist. I'm excited because I’ve been suffering from what appears to be psoriatic arthritis for 25 years, but no one would say I had it. I knew I had it, but couldn’t get everyone else to see it. I’ve been experiencing swelling, pain, stiffness in my joints. I’m still confused to this day why it took so long for the correct diagnosis.

On the day of my appointment, I was prepared to tell the doctor all of my symptoms and medical history. I understand the more detailed information I give the doctor the better it will be for reaching a conclusive diagnosis. I was very nervous and felt anxious. The good news is when you know that you know you can identify the condition - put a name to what you're experiencing - it feels so rewarding.

I also had to have x-rays on the day of my appointment. Diagnostic imaging can reveal so much about the joints, bones, blood cells. I was also prepared for my MRI. It speaks volumes to what these machines can detect in our arthritic bodies. They can detect advanced stages of psoriatic arthritis. They are looking at erosions, the synovial joint, and the fibrocartilage joint, sacroiliac joint and all our tendons and ligaments.

The ultrasound was done to detect the inflammation which is a part of this disease.

For years psoriatic arthritis was believed to be a mild disease, yet recent studies show that it can lead to significant deformations and severe joint damage. Research shows 40% of patients with psoriatic arthritis having x-rays done have shown erosive joint damage. I have some joint damage, but with the proper treatment that I am getting now. I am able to function.

I feel this is a rather high percentage and also rather startling. It simply goes to show that you can’t judge a book by its cover. These imaging centers have really been phenomenal in helping the world of those with psoriatic arthritis to get the proper treatment.

Knowledge is power

I have said this so many times in my life, knowledge is power. It is so important for those with this disease to get the proper diagnosis. Utilize the diagnostic imaging centers. The tests paint a picture of how your disease has progressed; remained the same; erosions; curving of spine or joint deformity. It means whether you can walk or not walk. Many patients spines have become to the point where being mobile is impossible.

If you suspect you may have psoriatic arthritis, don’t wait until it’s too late. Get to a specialist and get diagnosed. Get a second or third opinion if you need to. I am glad to finally get my diagnosis, but most importantly I am getting the proper treatment after all these years.

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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imschmarte Member
I too have PsA, and I can not believe it took so long for you to get a diagnosis! Do you have psoriasis? My rheumatologist diagnosed mine the first time I saw him, and blood tests and xrays and other tests showed he was right. Now that you have a diagnosis, hopefully you can get on some of the drugs they have, can can stop the progression of the disease. I was on Remicaid for 10 years, and I felt wonderful. My insurance changed, and now I can't get any of the biologics,, and I have gone downhill SO fast in the last couple years. Drug companies have made BILLIONS off of these drugs, and the prices keep going up, it is so sad!! I am glad that you were able to get on the drugs you need, and have regained function in your joints! Good luck to you Diane T!
1. Diane T Moderator & Contributor
 I have had psoriasis since 1963. This is why I am still surprised to this day that I was not given the proper diagnosis. You are right the drug company is making billions of dollars. I am on Stelera right now. I have been on it for 4 years and it has stop working. My insurance company told me that my shot was $21,000 for one shot. That is crazy. I pray that you get the help that you need. Trust me, I know what you are going though. Hugs, Diane
karenm Member
Over the past two decades, the diagnostic processes available to assist with and support a PsA diagnosis, or rule it out, have improved. Also, there is a much clearer understanding of the various possible ways the disease can impact the body. One very important and critical symptom is enthesitis. Knowledge and understanding of enthesitis, and its potentially significant impacts on those with PsA, had been, until quite recently, very limited. In relationship to diagnosis, enthesitis often does not show up in CRP tests, cannot be seen in x-rays, and can easily be missed in MRI's. Yet it can occur anywhere in the body, and can be extremely painful, even disabling. So, if there are clues that you may be dealing with PsA, be sure to review the possibility of enthesitis, and potential treatments, with your doctor.