Psoriatic Arthritis vs. Rheumatoid Arthritis: What’s the Difference?

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Rheumatoid arthritis diagnosis versus psoriatic arthritis diagnosis

Finding out the root cause of your symptoms is important to not only feeling better but also preventing long-lasting joint damage before it starts. If you’re able to, the Arthritis Foundation recommends seeing a doctor who specializes in treating inflammatory joint diseases, called a rheumatologist (your primary care doctor can give you a referral if needed). Your doctor should ask about your medical history, including your symptoms and whether anyone in your family has arthritis, psoriasis, or another autoimmune disease. Then your doctor will examine your body to look for joint swelling that can indicate either form of arthritis.

From there, if either condition is suspected, your doctor can check your blood for erythrocyte sedimentation rate (ESR or “sed rate”) and C-reactive protein (CRP), which are markers of bodily inflammation. These tests show that you have inflammation, but they don’t confirm the exact cause of it, Dr. Dubreuil says. Your doctor may also request a specific blood test to look for proteins called rheumatoid factor (RF) and cyclic citrullinated peptide (CCP), which are typically higher in people who have rheumatoid arthritis, according to the Mayo Clinic. This test can only indicate that you might have an autoimmune condition, as people can have higher levels of these proteins and not have an autoimmune condition.

Your doctor might also recommend an X-ray to look for bone, tendon, or ligament damage, but this is usually most helpful in a more developed disease. “In people whose joint pain or swelling started recently, we often don’t see anything on X-ray,” Dr. Dubreuil says. “Then we often move on to a more advanced technique.” That might include magnetic resonance imaging (MRI) or ultrasound to unveil possible swelling in the soft tissues.

For a psoriatic arthritis diagnosis specifically, you may also need to see a dermatologist to confirm if you also have signs of psoriasis, since the two conditions are so often intertwined. “The physical exam is very important to look for psoriasis in hidden areas and nail changes that might suggest psoriasis,” Dr. Dubreuil says. For example, changes in your nails can include pitting or your nails separating from your nail beds. 

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Rheumatoid arthritis treatment versus psoriatic arthritis treatment

Can rheumatoid arthritis go away? Can you reverse psoriatic arthritis? These are questions you may ask yourself at some point following your diagnosis and, unfortunately, the answer is there is no cure for either condition. However, you can absolutely feel better with treatment and feel more in control of your life. Regardless of your diagnosis, rheumatoid arthritis treatment and psoriatic arthritis treatment overlap quite a bit, because the goal is to get your inflammation under control and to prevent long-term joint damage. 

You may start by trying nonsteroidal anti-inflammatory drugs (NSAIDs) to tamp down inflammation, which drives the pain, tenderness, and swelling. Corticosteroids are another drug that suppresses inflammation and are commonly prescribed via oral medications or injection. Prescription medications called disease-modifying antirheumatic drugs (DMARDs) can also help slow the progression of either disease, according to the Mayo Clinic. If your symptoms don’t improve, then your doctor might switch you to a different type of DMARD or to a class of medications known as biologics, which are delivered via IV infusion or injection to help target the specific parts of your immune system involved in causing autoimmune conditions.