Psoriatic Arthritis.

Diagnosis and evaluation

Diagnosis

To find out if you have psoriatic arthritis, your doctor will ask you about your symptoms and will perform a physical examination.

Since the symptoms of this type of arthritis are similar to other forms of arthritis, such as gout, Reiter's syndrome, and rheumatoid arthritis, the doctor may also perform some or all of the following tests:

• X-rays to look for changes in your bones and joints
• blood tests to rule out other diseases, such as rheumatoid arthritis and document the presence of inflammation
• joint fluid tests to rule out gout, another arthritis-related disease that may resemble psoriatic arthritis. The joint fluid in most people with psoriatic contains many inflammatory cells and although the absence of uric acid crystals may rule out gout, many other inflammatory forms of arthritis will have a similar number of white cells in the fluid. The knee is the easiest joint from which to obtain joint fluid for analysis and can only be removed by putting a needle in the joint (the procedure is called arthrocentesis) if the joint is swollen.

It may take some time to determine if you have psoriatic arthritis. Usually, if your nails and skin are affected along with your joints, a concrete diagnosis can be made. In general, a rheumatologist (a physician trained in the diagnosis and treatment of arthritis) can recognize the features of psoriatic arthritis noted above in the setting of psoriasis and make a diagnosis. A firm diagnosis will have to wait the development of the skin disease. The skin disease or the arthritis may appear first.

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