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The Differences Between PsA and RA. 

 January 31, 2024

By  Linda Rook

various painful joint in your body.

Introduction.

Arthritis is a term that surrounds various inflammatory joint disorders, that have a range of complex conditions that affect millions of people worldwide. With 100 different types of arthritis, I shall explain two that are similar but different in some ways. They are psoriatic arthritis (PsA) and rheumatoid arthritis (RA), for accurate diagnoses you should understand the differences.

In this blog I will aim to help you with the unique features that PsA and RA gives. I shall show you how to help yourself through these terrible diseases, from effective management to improved outcomes for those who are living with these conditions.

Rheumatoid Arthritis (RA):

Rheumatoid Arthritis, is an autoimmune condition that attacks your immune system by mistakenly attacking the synovium, which is the lining of membranes around the joints. You may  suffer long-lasting inflammation that can lead to your joints being swollen, painful, and can damage your joints.  RA often shows a symmetrical pattern, which means if you get RA in the right wrist, you will get it in your left wrist.

Psoriatic Arthritis (PsA):

But on the other hand, Psoriatic Arthritis is also a complex autoimmune disorder that not only affects the joints but is also linked with psoriasis, which is a chronic skin condition. The symptoms of which are red, scaly patches. The main symptoms of PsA could be pain, swelling, and stiffness, in the joints, also your nails and even the eyes can be affected.

Understanding Rheumatoid Arthritis.

Rheumatoid arthritis or (RA), is an autoimmune disorder that affects the joints, that can cause inflammation and if it goes untreated could lead to deformity. The autoimmune diseases, mean that the immune system, which helps to protect the body from viruses and bacteria, wrongly attacks its tissues. As in rheumatoid arthritis, your immune system targets your synovium, this is the lining of your membranes which surrounds the joints.

Key features include:

  1. Joint Inflammation:
  2. Symmetrical Joint Involvement: 
  3. Morning Stiffness: 
  4. Systemic effects:
  5. Rheumatoid Nodules:
  6. Joint Damage:
Pain in Fingers

Your doctor will give you an examination, blood tests and imaging studies to assess joint damage.

The treatment that you may be getting will aim to reduce inflammation, relieve the symptoms, and prevent joint damage.

You may be given medications such as disease-modifying antirheumatic drugs (DMARDs), biologics, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroids.

Also, you may be taken to physical therapy and joint protection techniques that play important roles in managing the condition and improving your quality of life.

Understanding Psoriatic Arthritis: 

Psoriatic arthritis (PsA) is a chronic inflammatory condition that affects some of you that has psoriasis, which is a skin disorder.  The symptoms are red, scaly patches. This autoimmune disease not only affects the skin but also involves the joints, leading to pain, stiffness, and swelling.

A weekly box of medication.

Key features of psoriatic arthritis include:

Psoriatic arthritis can have various symptoms that may differ from person to person. Common signs that you could develop include joint pain, swelling, and stiffness, particularly in the fingers, toes, wrists, knees, and ankles. Psoriasis skin lesions often precede joint symptoms, but this is not always the case.

Rheumatologists evaluate a combination of factors, including your medical history, and a physical examination, and you may be taken for an X-ray and MRI scan, as well as blood tests that can show your inflammation markers and the presence of specific antibodies.

The overall treatment is to manage your symptoms, control inflammation, and prevent joint damage. Managing the symptoms could include medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologics commonly prescribed to alleviate symptoms and slow disease progression. 

You may also be taken to physical therapy for some physical activity, these can include joint-friendly exercises, which are low impact, maintain flexibility and reduce stiffness. Weight management is also important, as excess weight can worsen joint pain.

Understanding the differences between Psoriatic Arthritis and Rheumatoid Arthritis.

The next is a list that shows the differences between psoriatic arthritis and rheumatoid arthritis.   

1.    Trigger Factors:

•     Psoriatic Arthritis: This is associated with psoriasis, which is a chronic skin condition, and can develop in people who already have psoriasis, but joint symptoms may go before the presence of the skin.

•     Rheumatoid Arthritis: Is an autoimmune disorder where the immune system mistakenly attacks the synovium, which is the lining of the membranes that surround the joints.

2.    Clinical Presentation:

•     Psoriatic Arthritis: In addition to joint pain and swelling, PsA can involve the skin, nails, and other organs.

•     Rheumatoid Arthritis: mainly affects the joints, causing symmetrical joint pain and swelling also nodules may appear that are lumps under the skin.

3.    Joint Involvement:

•     Psoriatic Arthritis: PsA can affect any joint, including the small joints of the fingers and toes, and the spine can also be affected, leading to spondylitis.

•     Rheumatoid Arthritis: RA often affects the small joints of the hands and feet symmetrically. Larger joints such as the knees, shoulders, and hips may also be involved.

4.    Laboratory and Imaging Findings:

•     Psoriatic Arthritis: Elevated levels of inflammation markers (like C-reactive protein or erythrocyte sedimentation rate) can be observed. Imaging may reveal features like deformities.

The lumber spine diagram

•     Rheumatoid Arthritis: Blood tests often show the presence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies. Imaging may reveal joint erosion and damage.

Knee Joint

5.    Treatment Approaches:

•     Psoriatic Arthritis: Treatment aims to control joint inflammation, manage skin symptoms, and prevent joint damage. You may be prescribed with drugs called Nonsteroidal anti-inflammatory drugs or NSAIDs or disease-modifying antirheumatic drugs DMARDs, and biologics.

•     Rheumatoid Arthritis: Like PsA, treatment for RA involves DMARDs and biologics to suppress inflammation. Corticosteroids and NSAIDs may also be used for symptom relief.

6.    Prognosis:

•     Psoriatic Arthritis: The prognosis varies, but early diagnosis and effective treatment can help manage symptoms and prevent joint damage.

•     Rheumatoid Arthritis: Timely and appropriate treatment can slow down the progression of RA and improve long-term outcomes.

Conclusion.

While both psoriatic arthritis and rheumatoid arthritis share commonalities, their distinctive features require different approaches to diagnosis and management. Understanding these differences is crucial for healthcare professionals to provide tailored and effective care for your conditions. Early diagnosis plays a essential role in improving the quality of your life.

RA is mainly an autoimmune disorder affecting the synovium, while PsA is closely associated with psoriasis.

PsA exhibits a broader range of symptoms, including joint involvement, skin lesions, dactylitis, and enthesitis. RA mainly targets joints symmetrically, causing morning stiffness, and may lead to the development of rheumatoid nodules.

PsA can affect any joint, including the small joints and the spine. RA often involves symmetrically paired joints, particularly your hands and feet, and may affect larger joints.

While both conditions are managed with a combination of medications like disease-modifying antirheumatic drugs (DMARDs) and biologics, the specific treatment approach may vary. PsA often treatments your skin symptoms as well, while RA management mainly focuses on joint inflammation.

Distinguishing between RA and PsA allows healthcare professionals to tailor your treatment plan to your unique condition, ensuring the best care and improved outcomes. Early diagnosis, and ongoing monitoring are essential for effective management for both Rheumatoid Arthritis and Psoriatic Arthritis.

Please subscribe to my website and I will keep you updated on new blogs. Also, if you need to know anything about arthritis, please don't hesitate just leave me a message on my contact page  and I will get back to you. 

In the meantime, if this post is informative, I would be very grateful if you would help your friends or family if they have a similar condition to tell them. So please share it on Twitter (X), or Facebook or send them an email.

I am not a medical professional, and this blog is for information only. If you have any worries, you should consult your doctor.

I hope this blog has helped.

More Reading:

https://rmdopen.bmj.com/content/4/2/e000656

https://www.psoriasis.org/advance/psoriatic-arthritis-or-rheumatoid-arthritis/

Linda Rook

Linda is now retired and has suffered from Osteoarthritis for about 40+ years.  She struggled with her weight until she found the correct one that also helped with her arthritic pain.  Linda was in terrible pain until the physician thought her right hip needed replacement. 


Now Linda has an artificial right hip, which has left her with the left leg shorter than the right.  Therefore, her spine is now wonky, and has arthritis of the lower back, also it seems to be going all over the body, her pain is now in the knees, elbow, wrist, fingers and both hips.


Linda now spends her days writing information to help others with the same conditions, so they do not suffer like Linda.


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Coping With Pregnancy and Chronic Illness.

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