Diagnosing Psoriatic Arthritis

In the absence of a definitive diagnostic test for psoriatic arthritis (PsA), your health care provider will diagnose you by examining your skin, nails, joints and other symptoms. You may have X-rays, an MRI, an ultrasound and blood tests as well.

A medical diagnosis chart with psoriatic arthritis written on it.

PsA may sometimes be incorrectly diagnosed as other types of arthritis or other conditions. However, PsA has characteristics and unique symptoms that may be present and can help your provider reach the correct diagnosis.

Look for one or more of these symptoms:

  • Generalized fatigue
  • Tenderness, pain and swelling with tendons and ligaments
  • Swollen fingers and toes
  • Stiffness, pain, throbbing, swelling and tenderness in one or more joints
  • A reduced range of motion
  • Morning stiffness and tiredness
  • Nail changes—for example, the nail separates from the nail bed and/or becomes pitted and mimics fungus infections
  • Redness and pain of the eye, such as conjunctivitis

In 85 percent of people with PsA, skin disease precedes joint disease.

Therefore, if you have psoriasis, it is important to tell your dermatologist if you have any aches and pains.

(Gladman, Antoni, Mease, Clegg, & Nash, 2005)

Did You Know?

Having a severe case of psoriasis does not necessarily mean you will develop PsA. Conversely, you could have few skin lesions, but have many joints affected by PsA.

How to Talk to Your Health Care Provider About Symptoms

By taking this short screening assessment, the Psoriasis Epidemiology Screening Tool (also known as PEST), you may help your health care provider make a diagnosis.

Bring your quiz results and the diagram to your appointment. Circle all of the places on the diagram where your body feels tender or sore. This way, you won’t forget to mention important symptoms. Even if you’re not feeling them on the day of your appointment, you should still bring them up with your provider.

Describe symptoms as precisely as possible. For example, instead of saying, “My knee hurts,” say “There is a sharp, piercing pain on the outside of my left knee, under the kneecap.”

Prepare five main questions you’d like to ask your provider. You’re probably wondering about many  things concerning your health right now. Boiling them down to five main questions will help focus your conversation with your provider, and give your provider enough time to give you complete answers.

For example, you could ask about:

  • Symptoms you are experiencing
  • New medications or dietary supplements
  • Information from other health care providers you see
  • Treatments you are interested in
  • How treatments might affect you

Be specific, open and honest. If you don’t understand anything your health care provider is saying, speak up. Also, if your provider is recommending a treatment that you don’t think is right for you, say so. It’s OK to ask about other treatment options.

The PsA Diagnosis Project

Learn about NPF’s research push to fund and develop a diagnostic test for PsA. Early recognition, diagnosis and treatment of PsA can help prevent or limit the extensive joint damage that occurs in later stages of the disease.

Connect with the Patient Navigation Center

A rheumatologist is an important member of your health care team. The Patient Navigation Center can help you locate and connect with a rheumatologist in your area who has experience with treating patients with PsA. 

Get in touch today

Gladman, D. D., Antoni, C., Mease, P., Clegg, D. O., & Nash, P. (2005). Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis, 64 Suppl 2, ii14-17. doi:10.1136/ard.2004.032482

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