Is it true that there is no test to determine if someone has psoriatic arthritis?

Joint pain

Synopsis

Yes, it is true that there is no test to determine if someone has psoriatic arthritis. However, it is a very real disease and specialists (rheumatologists and dermatologists) can still find evidence that someone is suffering from it or not. If you already have psoriasis, remember that you are more likely than the rest of the population to be affected by psoriatic arthritis. (See answer to Are people with psoriasis more likely to develop psoriatic arthritis?) It is important to find a treatment because psoriatic arthritis can seriously affect the quality of life.

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Expert Answers

Dr. Marc Bourcier:

The answer is yes, it is true: there are no tests to determine if you have psoriatic arthritis. For example, with diabetes, we can determine with a blood test if you have it. But it does not work this way with arthritis. However, there are diagnostic criteria that will make us suspect we are dealing with psoriatic arthritis. These include physical examination, as well as blood tests and X-rays. This is why we often work with rheumatologists when dealing with psoriatic arthritis. But even with all that, it is not always easy to know, positively, if someone has psoriatic arthritis.

We already know that about one third of patients with psoriasis will develop a specific form of arthritis called psoriatic arthritis. (See answer to Are people with psoriasis more likely to develop psoriatic arthritis?)

If a patient with psoriasis experiences significant joint problems, a referral to a rheumatologist will help to determine the nature of the joint symptoms. Patient with psoriasis may also develop other forms of arthritis, like osteoarthritis. It is not uncommon that some of them get two or more types of arthritis.

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Andrew Gosse:

Yes, it is true. There are no blood tests or other forms of objective measurement that can positively determine if you have psoriatic arthritis or not.

I know that dermatologists and rheumatologists have been working closely together in order to develop protocols and tools to be more efficient in screening for psoriatic arthritis. As a whole, knowledge about autoimmune diseases has advanced tremendously in the last decades, and medical researchers are getting closer to developing tests for psoriasis and psoriatic arthritis. 

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Sandra Walsh:

It is true that there is no definitive test for psoriatic arthritis. A rheumatologist, who specializes in diseases and conditions that involve the connective tissues such as the joints and tendons, makes the diagnosis of psoriatic arthritis based on an assessment of signs and symptoms that meet a certain number of criteria for the disease. First, the patient must have evidence of inflammatory articular disease (pain and /or swelling in a joint, the spine, and/or the point where the tendon attaches to the bone). Once this is established, X-rays and bloodwork will be ordered and the rheumatologist will determine if the patient meets three of the following criteria that will confirm the diagnosis of psoriatic arthritis:

  1. The patient currently has psoriasis, has been diagnosed by a qualified physician of having psoriasis in the past, or has a first or second degree relative with psoriasis.
  2. The patient has psoriasis affecting the nails.
  3. The patient’s blood test for RF factor is negative (This is an indicator for rheumatoid arthritis)
  4. The patient currently has swelling of an entire finger or toe (dactylitis) or it has been documented by a rheumatologist in the past.
  5. X-ray evidence for new bone formation around a joint.

 

If you have psoriasis, my advice is to not assume that aches and pains in your joints or in your back are normal and a result of aging. If you are having pain and/or swelling in your joints, have a swollen finger or toe, or have stiffness that lasts for a prolonged period in the morning, talk to your healthcare provider. You may be suffering from psoriatic arthritis which can lead to joint damage if it is not treated.

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Painful joints might hide something else

I want to know what it is