- High percentage of patients diagnosed with psoriatic arthritis were found to be previously diagnosed with osteoarthritis and psoriasis
- Axial symptoms (back pain), enthesitis, and tendonitis were common in patients prior to getting a diagnosis of psoriatic arthritis
The sooner you’re diagnosed with a chronic inflammatory disease, the sooner you can start treatment and begin feeling better. Unfortunately, for many people with psoriatic arthritis (PsA) — a type of inflammatory arthritis characterized by joint pain and skin disease (psoriasis) — it can take years to get a proper diagnosis.
But more research is revealing early signs of psoriatic arthritis that might help them identify people with PsA faster.
Symptoms that Come Before a PsA Diagnosis
A new study, published in Arthritis Research & Therapy, and led by Alexis Ogdie, MD, at the University of Pennsylvania Perelman School of Medicine aimed to determine whether any specific health problems tended to precede an eventual diagnosis of PsA.
Researchers utilized insurance claims data that was collected between January 2006 and April 2019. They focused on 13,661 patients with confirmed psoriatic arthritis who had been in the insurance database for at least six years and compared them to control subjects in the database who did not have PsA. Dr. Ogdie and her team found that “nonspecific musculoskeletal manifestations and non-PsA diagnoses were common up to six years” before PsA diagnosis and occurred far more frequently than they did in the control group.
According to their findings, 48 percent of people later diagnosed with PsA had been previously diagnosed with osteoarthritis, 18 percent with rheumatoid arthritis; and 61 percent with psoriasis.
They found that PsA patients tended to be diagnosed with an increasing number of conditions related to arthritis before ultimately being diagnosed with PsA, including:
- Axial symptoms (such as back pain)
- Enthesitis (inflammation of the spot where tendons and ligaments connect to bones)
- Tendonitis (inflammation of a tendon)
There was also a spike in the number of study participants who were diagnosed with psoriasis in the six months prior to their PsA diagnosis.
Other research has shown that it often takes more than two years for someone with PsA to be correctly diagnosed. That’s a problem, because even a “six-month delay from PsA symptom onset to initial rheumatology consult may lead to joint erosion and damage,” Dr. Ogdie and her colleagues wrote. (Read about diseases that can mimic PsA — and delay your diagnosis.)
“Collectively, our study may indicate an opportunity for earlier detection of PsA as characterized by nonspecific musculoskeletal manifestations and skin symptoms,” wrote the study authors. “Increased awareness and understanding of diagnostic barriers may lead to timelier diagnosis, cost savings, and appropriate intervention to improve outcomes.”
The takeaway: Don’t wait to see a doctor if you’re experiencing skin psoriasis, or symptoms like back pain, enthesitis, or tendinitis. The sooner you get a PsA diagnosis, the sooner you can start treatment to prevent joint damage and slow systemic inflammation.
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‘Build-up’ of arthritis, axial symptom diagnoses often precede PsA diagnosis. Healio Rheumatology. October 2021. https://www.healio.com/news/rheumatology/20211019/buildup-of-arthritis-axial-symptom-diagnoses-often-precede-psa-diagnosis.
Karmacharya P, et al. Diagnostic delay in psoriatic arthritis: a population-based study. Journal of Rheumatology. February 2021. doi: https://doi.org/10.3899/jrheum.201199.
Ogdie A, et al. Longitudinal analysis of the patient pathways to diagnosis of psoriatic arthritis. Arthritis Research & Therapy. September 2021. doi: https://doi.org/10.1186/s13075-021-02628-2.