Distinguishing rheumatoid arthritis from psoriatic arthritis
Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) have key differences in clinical presentation, radiographic findings, comorbidities and pathogenesis to distinguish between these common forms of chronic inflammatory arthritis. Joint involvement is typically, but not always, asymmetric in PsA,...
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BMJ Publishing Group
2018-08-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/4/2/e000656.full |
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| author | Joseph F Merola Luis R Espinoza Roy Fleischmann |
| author_facet | Joseph F Merola Luis R Espinoza Roy Fleischmann |
| author_sort | Joseph F Merola |
| collection | DOAJ |
| description | Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) have key differences in clinical presentation, radiographic findings, comorbidities and pathogenesis to distinguish between these common forms of chronic inflammatory arthritis. Joint involvement is typically, but not always, asymmetric in PsA, while it is predominantly symmetric in RA. Bone erosions, without new bone growth, and cervical spine involvement are distinctive of RA, while axial spine involvement, psoriasis and nail dystrophy are distinctive of PsA. Patients with PsA typically have seronegative test findings for rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibodies, while approximately 80% of patients with RA have positive findings for RF and CCP antibodies. Although there is overlap in the pathogenesis of PsA and RA, differences are also present that affect the efficacy of treatment. In PsA, levels of interleukin (IL)-1β, IL-6, IL-17, IL-22, IL-23, interferon-γ and tumour necrosis factor-α (TNF-α) are elevated, and in RA, levels of IL-1, IL-6, IL-22, IL-33, TNF-α, chemokine ligand 11 and chemokine C-X-C motif ligand 13 are elevated. Differences in the pathogenesis of RA and PsA translate into some variances in the specificity and efficacy of therapies. |
| format | Article |
| id | doaj-art-8330f539330f439eac0bdbc10d46e922 |
| institution | Kabale University |
| issn | 2056-5933 |
| language | English |
| publishDate | 2018-08-01 |
| publisher | BMJ Publishing Group |
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| series | RMD Open |
| spelling | doaj-art-8330f539330f439eac0bdbc10d46e9222025-02-10T12:00:09ZengBMJ Publishing GroupRMD Open2056-59332018-08-014210.1136/rmdopen-2018-000656Distinguishing rheumatoid arthritis from psoriatic arthritisJoseph F Merola0Luis R Espinoza1Roy Fleischmann28 Department of Dermatology and Department of Medicine, Division of Rheumatology, UT Southwestern Medical Center, Dallas, Texas, USA2 Section of Rheumatology, LSU Health Sciences Center at New Orleans, New Orleans, Louisiana, USAUniversity of Texas Southwestern Medical Center, Metroplex Clinical Research Center, Dallas, Texas, USARheumatoid arthritis (RA) and psoriatic arthritis (PsA) have key differences in clinical presentation, radiographic findings, comorbidities and pathogenesis to distinguish between these common forms of chronic inflammatory arthritis. Joint involvement is typically, but not always, asymmetric in PsA, while it is predominantly symmetric in RA. Bone erosions, without new bone growth, and cervical spine involvement are distinctive of RA, while axial spine involvement, psoriasis and nail dystrophy are distinctive of PsA. Patients with PsA typically have seronegative test findings for rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibodies, while approximately 80% of patients with RA have positive findings for RF and CCP antibodies. Although there is overlap in the pathogenesis of PsA and RA, differences are also present that affect the efficacy of treatment. In PsA, levels of interleukin (IL)-1β, IL-6, IL-17, IL-22, IL-23, interferon-γ and tumour necrosis factor-α (TNF-α) are elevated, and in RA, levels of IL-1, IL-6, IL-22, IL-33, TNF-α, chemokine ligand 11 and chemokine C-X-C motif ligand 13 are elevated. Differences in the pathogenesis of RA and PsA translate into some variances in the specificity and efficacy of therapies.https://rmdopen.bmj.com/content/4/2/e000656.full |
| spellingShingle | Joseph F Merola Luis R Espinoza Roy Fleischmann Distinguishing rheumatoid arthritis from psoriatic arthritis RMD Open |
| title | Distinguishing rheumatoid arthritis from psoriatic arthritis |
| title_full | Distinguishing rheumatoid arthritis from psoriatic arthritis |
| title_fullStr | Distinguishing rheumatoid arthritis from psoriatic arthritis |
| title_full_unstemmed | Distinguishing rheumatoid arthritis from psoriatic arthritis |
| title_short | Distinguishing rheumatoid arthritis from psoriatic arthritis |
| title_sort | distinguishing rheumatoid arthritis from psoriatic arthritis |
| url | https://rmdopen.bmj.com/content/4/2/e000656.full |
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