This article is first seen at British Medical Journal.
Citation: Merola JF, Espinoza LR, Fleischmann R. Distinguishing rheumatoid arthritis from psoriatic arthritis RMD Open 2018;4:e000656. doi: 10.1136/rmdopen-2018-000656
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Abstract
Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) exhibit distinct variations in their clinical presentation, radiographic findings, comorbidities, and underlying causes, which enable differentiation between these common forms of chronic inflammatory arthritis.
While joint involvement tends to be asymmetric in PsA, it is generally symmetrical in RA, although exceptions exist.
Noteworthy attributes of RA encompass bone erosions devoid of new bone growth and cervical spine engagement, whereas PsA is characterized by axial spine involvement, psoriasis, and nail dystrophy.
Patients with PsA commonly exhibit negative test results for rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibodies, whereas about 80% of RA patients test positive for RF and CCP antibodies. While there are shared aspects in the pathogenesis of PsA and RA, disparities are also present that influence the effectiveness of treatments.
PsA often shows heightened levels of interleukin (IL)-1β, IL-6, IL-17, IL-22, IL-23, interferon-γ, and tumor necrosis factor-α (TNF-α), whereas RA is marked by elevated levels of IL-1, IL-6, IL-22, IL-33, TNF-α, chemokine ligand 11, and chemokine C-X-C motif ligand 13.
These divergences in the underlying causes of RA and PsA translate into certain differences in the specificity and efficacy of therapeutic interventions.
Link to the full Article (Britist Medical Journal):
https://rmdopen.bmj.com/content/rmdopen/4/2/e000656.full.pdf
