Another test is a complete blood
count (CBC), which is exactly that, a count of all the
cells of the blood: red blood cells, white blood cells
and platelets. Red blood cells are important (they carry
oxygen from the lungs to the rest of the body) and their
levels can be reduced in those with psoriatic arthritis
or other types of inflammatory arthritis. A decrease
in the level of red blood cells is called anemia.
Joint
Aspiration - Psoriasis Treatment
A joint aspiration involves using
a syringe to take fluid from a swollen joint. Examining
the fluid for white blood cells, infection or crystals
found in other causes of arthritis, can be very important
for establishing the correct diagnosis.
X-rays
- Psoriasis Treatment
X-rays are helpful in making a
correct diagnosis of psoriatic arthritis, and in evaluating
the extent and severity of the arthritis. Sometimes
people with psoriatic arthritis have little or no joint
pain, so joint destruction can go unnoticed. An X-ray
can show specific changes that help distinguish psoriatic
arthritis from other types of arthritis. In addition,
an X-ray can determine the extent of the damage to the
joints and provide a baseline with which to compare
later X-rays. The areas typically involved are the end
and middle knuckle joints, the spine, lower back at
the base of the spine (sacroiliac joints), and at the
site of tendon or ligament insertions to bone (entheses).
If psoriasis is evident or psoriatic arthritis is suspected,
X-rays of the hands, wrists, feet and sacroiliac joints
may be taken. Other areas can be X-rayed, depending
on the patient's symptoms.
How Is Psoriatic Arthritis
Treated?
Treatment includes managing both
arthritis and skin lesions, when both are present, and
will depend on the severity of the psoriasis and psoriatic
arthritis. In many cases, the treatments are complementary,
that is to say, if a dermatologist is treating your
skin lesions with a systemic agent such as methotrexate
or etanercept, this treatment could also help your psoriatic
arthritis. In many cases, patients with psoriatic arthritis
will be referred to a rheumatologist. In most cases,
your doctors (dermatologist, rheumatologist, family
physician) will work together to help find the best
treatment. The dermatologist usually continues to follow
your treatments and provide guidance for the care of
your skin. Treatments for psoriatic arthritis include:
Non-steroidal Anti-Inflammatory
Drugs (NSAIDs)
slow-acting antirheumatic drugs
(SAARDs)/disease modifying antirheumatic drugs (DMARDs)
methotrexate
cyclosporine
antimalarials
gold
penicillinamine
sulfasalazine
Biologic Agents
etanercept
Experimental
Biologic Agents
alefacept
infliximab
adalimumab
Non-Medical Treatments
In addition to oral or injectable
medications, there are a number of non-medical, physical
and surgical treatments for psoriatic arthritis. The
management of psoriatic arthritis is a team approach.
In addition to your family doctor, dermatologist and
rheumatologist, you may work with a physiotherapist
or occupational therapist.
Physiotherapy
Physiotherapists are university-trained
health care workers who try to help people achieve their
highest level of physical function. Physiotherapists
can develop and implement personalized programs that
can:
increase mobility and improve
endurance
restore and increase range of
motion in joints
control pain
educate patients about their
condition and pain control techniques
Exercise
Moderate to low-impact exercise can:
maintain and improve joint range
of motion
reduce weight and pressure on
joints
improve aerobic capacity and
cardiovascular fitness
relieve joint stiffness and pain
improve strength
Hydrotherapy/AquatherapyLaboratory
and Blood Tests
There is no single laboratory
test that is diagnostic of psoriatic arthritis. Certain
laboratory tests are usually performed to determine
if there could be another cause for the arthritis. There
are two important blood tests, including the rheumatoid
factor and the antinuclear antibody (ANA).
The first test was described earlier;
the second test excludes the presence of systemic lupus
erythematosus (lupus). Antinuclear antibody is found
in about 95 percent of people with lupus, but rarely
in psoriatic arthritis. Because lupus symptoms are similar
to those of psoriatic arthritis, a negative antinuclear
test can help rule out lupus.
Your doctor could also order other
blood tests to monitor the progress of your disease,
rather than for diagnostic purposes. For example, an
Erythrocyte Sedimentation Rate (ESR) is a nonspecific
test that can reflect the degree of joint inflammation.
Another test is a complete blood
count (CBC), which is exactly that, a count of all the
cells of the blood: red blood cells, white blood cells
and platelets. Red blood cells are important (they carry
oxygen from the lungs to the rest of the body) and their
levels can be reduced in those with psoriatic arthritis
or other types of inflammatory arthritis. A decrease
in the level of red blood cells is called anemia.
control pain
educate patients about their
condition and pain control techniques
Hot
or Cold Therapy
Hot wraps with a towel or hot
pack can relieve painful muscle soreness and joint pain.
Cold therapy can reduce swelling and tenderness of psoriatic
arthritis. A cheap and effective cold pack is a bag
of frozen vegetables. It can be easily molded to affected
joints, and the cold can help reduce the swelling and
pain of psoriatic arthritis.
Aquatherapy or water therapy
is a series of exercises performed in the pool. Exercises
performed in the water are low impact, and therefore
easier on painful, swollen joints.
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