Psoriatic Arthritis vs. Rheumatoid Arthritis: Here’s the Difference

If you’ve got sore, swollen joints, there’s a good chance you’ll come across arthritis as you’re searching for a cause of your symptoms. But finding the right treatment requires you to get a lot more specific than that. Arthritis is actually an umbrella term for more than 100 different conditions, according to the Centers for Disease Control and Prevention (CDC). And there are at least two types that might be responsible for your tender, achy joints: psoriatic arthritis and rheumatoid arthritis.

Even though they have some overlapping symptoms, the two conditions are decidedly different. Here’s what you need to know about psoriatic arthritis and rheumatoid arthritis.

Psoriatic arthritis and rheumatoid arthritis are both chronic inflammatory conditions.

With both diseases, an overzealous immune system mistakenly attacks healthy cells in your body. That, in turn, can result in joint pain, stiffness, and swelling, along with perpetual fatigue and other symptoms more specific to either disease. 

The causes of psoriatic arthritis and rheumatoid arthritis are still up in the air, but doctors suspect the diseases have an underlying genetic component that may make a person more susceptible to certain environmental triggers.

In any case, psoriatic arthritis and rheumatoid arthritis are both lifelong diseases that can occur in flares (times when symptoms are especially aggravated). And while there’s no cure for either disease, treatments for both psoriatic arthritis and rheumatoid arthritis have come a long way toward keeping symptoms at bay, sometimes even putting the disease into remission. Plus, the right medication can help protect your body from the permanent damage these conditions can cause if left untreated, so it’s important to work with your doctor to manage your disease.

Psoriatic arthritis often affects people who have psoriasis.

Having psoriasis, a disease that often causes inflamed, scaly patches of skin on areas like your knees, elbows, and scalp, puts you at greater risk of getting psoriatic arthritis down the road. The Cleveland Clinic estimates that up to 30% of people with psoriasis get diagnosed with psoriatic arthritis. However, it’s possible to get psoriatic arthritis even if you don’t have psoriasis, and vice versa. Psoriatic arthritis affects people of all genders at relatively equal rates and typically shows up in people between the ages of 30 and 50 years old, says the Cleveland Clinic.

NYU Langone Health explains there are five types of psoriatic arthritis, and depending on which one you have, the disease can show up in very different ways in your body. Around three-quarters of people with the condition have a type called asymmetric oligoarthritis, which impacts up to five joints, though not necessarily the same ones on both sides of the body. When that’s the case, it may be due to symmetric arthritis, a type of psoriatic arthritis that’s similar to rheumatoid arthritis. There’s also spondylitic arthritis, which affects the spine, and distal interphalangeal predominant psoriatic arthritis, which mainly involves the joints near your fingernails and toenails. The rarest form of psoriatic arthritis is arthritis mutilans. It’s a severe form of the disease that can destroy the bones in your hands, per the Mayo Clinic.

Up to 80% of people with psoriatic arthritis have nail changes, like pitting, crumbling, or grooves and ridges. In addition, foot pain, particularly in the back of your heel or sole, where the tendons and ligaments link up with bones, is common with psoriatic arthritis, as is lower back pain, per the Mayo Clinic.

The inflammation from psoriatic arthritis can also cause eye problems, such as uveitis. This condition can lead to permanent vision loss, so look out for early warning signs, like eye pain, redness, light sensitivity, and “floaters” blocking parts of your sight.

Rheumatoid arthritis doesn’t have that psoriasis link.

The Cleveland Clinic reports that women are diagnosed with rheumatoid arthritis at 2.5 times the rate of men. A common misconception about rheumatoid arthritis is that it’s an elderly person’s disease, but the truth is that it’s often diagnosed between the ages of 20 and 50.

While rheumatoid arthritis can affect people in different ways, its signature characteristics include tenderness, pain, and swelling in more than one joint, per the CDC. And although psoriatic arthritis may impact different joints on each side of the body, rheumatoid arthritis usually causes more symmetrical symptoms, says David Wanalista, D.O., rheumatologist at Atlantic General Rheumatology. As a progressive disease, it usually worsens with time, starting with the joints between your fingers and hands and toes and feet. The inflammation from rheumatoid arthritis can wear down your cartilage, and without that tissue acting as a shock absorber, your bones can eventually erode and lead to fusion of the joint.

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