What Are The Two Kinds Of Arthritis

What Are The Two Kinds Of Arthritis – Psoriatic arthritis (PsA) is a complex and often frustrating inflammatory arthritis that affects each patient differently. PSA is known to cause inflammation, stiffness, redness, pain, and damage to the skin, nails, joints, and more. Although it’s thought to look like rheumatoid arthritis but with skin involvement with psoriasis, psoriatic arthritis is actually an entirely different disease with unique risk factors, symptoms, and treatment options.

Most patients with psoriatic rheumatism already have psoriasis when they are diagnosed; It usually develops within five to 12 years of being diagnosed with psoriasis. However, Daphne D. Gladman explains. Director of the Center for Early Warning Studies of Rheumatic Diseases.

What Are The Two Kinds Of Arthritis

When it comes to psoriatic arthritis, no two patients are the same. Some individuals with RA have peripheral joint disease (where the hands, wrists, and knees are affected with joint symptoms), while others only have spinal involvement. However, other people may have both, says Brett Smith, MD, a rheumatologist at Blount Memorial Hospital in Alcoa, Tennessee.

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“Putting the puzzle together and making a formal diagnosis is difficult sometimes,” said Dr. “However, once diagnosed, these symptoms or disorders respond to similar treatments,” says Smith.

The most effective way to control psoriatic arthritis is to work with your rheumatologist to find the right combination of medications — and understanding the types and areas of psoriatic arthritis can help you do that.

There are five main types of psoriatic arthritis, categorized by the type of joint injury. People may only have one type at first, and then develop another type later.

Also known as asymmetric psoriatic arthritis, this type of PsA usually affects fewer than five large or small joints in your body. It is called “asymmetric” because joint symptoms such as pain and redness do not occur on either side of the body. You may have pain in the right knee but not the left, for example. About 35 percent of people with psoriatic arthritis have asymmetric oligoarthritis.

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As the name suggests, “symmetric” arthritis affects five or more joints on both sides of the body (for example, the right and left elbows), and the symptoms are similar to those of rheumatoid arthritis. This is the most common type of PsA and occurs in about half of people with the condition.

This type of PsA affects the peripheral joints (the distal joints between the phalanxes) of your fingers and toes and can cause nail changes such as mottling, pitting, or separation from the nail. Less than 20 percent of people with PsA have only distal arthritis. It often occurs with other types of psoriatic arthritis.

This severe form of psoriatic arthritis can deform and destroy the joints of your fingers, hands, wrists, and feet. Arthritis mutilans prevents your bone cells from breaking down and rebuilding, which can make your fingers look like a pair of opera glasses (“opera glass hand”) or like a telescope (“crossed finger”). Other symptoms of arthritis include swollen, shiny, wrinkled skin on the fingers. joint stiffness and immobilization due to fused bones (ankylos); Wears down the joints and bone tissue in the legs and arms. Thanks to increasing advances in psoriatic arthritis treatment, this complication of arthritis is rare, occurring in less than 5 percent of people with psoriatic arthritis.

Considered a type of spondyloarthritis, psoriatic arthritis is an umbrella term for many different types of arthritis with some common characteristics. (Ankylosing spondylitis and non-radiographic axial spondylitis are also types of spondyloarthritis, for example.) position). on each side of your spine). If left untreated, the vertebrae of the spine can fuse together. Your hands, feet, legs, arms and hips may also be affected. A new study finds that psoriatic arthritis with axial involvement is a separate condition that differs from having ankylosing spondylitis and psoriasis at the same time.

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However, while these five types describe the different presentations of psoriatic arthritis — and you can read about them online when searching for PsA — many rheumatologists do not use them to classify PsA in patients. “We’re starting to think more about people as a whole,” says Rebecca Habermann, MD, a rheumatologist at NYU Langone. “It’s not just about your joints or your skin — psoriatic arthritis can involve all parts of your body.”

In order to better diagnose and treat patients, experts have identified six distinct areas (or manifestations) that people with rheumatoid arthritis experience:

Not everyone with psoriatic arthritis has all six areas. Each person can experience their own set of areas that vary in severity. “Unfortunately, at this point, you can’t tell who will apply to the other fields or who will apply,” said Dr. Habermann says. The combination and severity of these areas influence how rheumatologists think about PsA treatment recommendations.

Peripheral arthritis spreads from one joint to another, affecting the large joints of the hands, arms (elbows and wrists), and legs (knees and ankles). People with peripheral arthritis are more likely to have swelling of the toes or fingers and enthesitis (inflammation of the place where tendons or ligaments attach to bones). says d. Habermann warns.

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Also known as spondylitis or spondyloarthropathy, axial arthritis causes pain and stiffness in the joints of the spine and the sacroiliac joints (at the base of the back). Estimates of the presence of focal disease in PSA vary widely, from 12 to 70 percent. says d. Habermann says.

Enthesitis, where a tendon or ligament meets bone, affects about half of people with psoriatic arthritis. Although there are many areas where engraftment can occur, people with rheumatoid arthritis most often experience it in the Achilles tendon (heel) or plantar fascia (bottom of the foot), as well as the epicondyle (elbow).

“Why the heel/toe is more common is not known, but one theory is that enthesitis is caused by microtrauma, and these areas may be more susceptible to injury,” said Dr. Habermann says.

Dactylitis is a painful, red, and hot swelling of a finger or toe. They are often called “sausage fingers” because they can make the fingers look like sausages. For many patients, finger inflammation is the first symptom of psoriatic rheumatic disease. “A patient with polydactyly should be clearly evaluated for skin and nail diseases,” Dr. says Gladman. “Sometimes the lesions are hidden in the scalp or near the anus, and the patient does not clearly appreciate them.”

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While some studies suggest that people with psoriasis have worse skin disease than people with psoriasis, only a very small part of the population can have psoriasis. In other cases, the presence of psoriasis on your body may indicate a risk of developing psoriatic arthritis. “Studies have shown that people with psoriasis affecting the scalp and nails are at a higher risk of developing rheumatoid arthritis,” Dr. says Gladman. PsA-infected skin psoriasis is different from psoriasis. These include signs and symptoms in the joint, axis, and attachment.

About 90 percent of people with psoriatic arthritis have nail involvement, including pitting and cracking of the nails, mottled petechiae (red spots on the white arch), and fissure hemorrhages (blood vessels under the nail). It can include the fingernails and toenails, and it can be one or all 20 nails, says dr. Habermann says.

Although there are clinical treatment guidelines from the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF), how PsA affects your body depends on the severity of your symptoms. .

In general, rheumatologists recommend using a “treat-to-target” approach (treating patients as aggressively as is necessary to achieve remission or a decrease in disease activity), which often includes prescribing TNF inhibitors (anti-TNF drugs). Orthomolecular Medicines (OSM).

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In addition to these guidelines, some medications have been found to work better in some areas than others. For example, traditional disease-modifying antirheumatic drugs (DMRDs) such as methotrexate (Trexal) and leflunomide (Arava) have been shown to act on the peripheral arthritis of PsA, but not the axial disease. However, these drugs are less effective for enthesitis and dactylitis. Gladman notes.

Habermann adds that newer biologics called IL-17 inhibitors, such as secukinumab (Cosentyx) and ixiquizumab (Taltz), may be better when patients have a deficiency.