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  • Q&A with Australian Health Practitioners

    What is difference between RA and psoriatic arthritis

    Related Topics
    Psoriasis Rheumatoid Arthritis Rheumatology
    I was told I have RA but my Rheumatologist says it's psoriatic arthritis.

    I don't have Psoriasis so how can it be psoriatic arthritis?

    There is no history in my family either.
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    Dr Simon Easterbrook-Smith

    Health Professional

    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile

    I know a bit about this as a health professional but *not* as a clinical health professional.
     
    Both rheumatoid arthritis and psoriatic arthritis are thought to be auto-immune diseases. That means that the immune system (which normally gets rid of pathogens like bacteria) “makes a mistake” and attacks normal body tissues.
     
    A common risk factor for psoriatic arthritis is inheriting a particular form of a protein called HLA-B27. The same applies to rheumatoid arthritis though the risk factor is different - inheriting a particular form of a protein called HLA-DR4,
     
    The HLA proteins are important in the immune system - they (skipping over some technical stuff) tell it which cells are pathogens (and should be got rid of) and which are normal (and so should be left alone).
     
    Apologies for the technicalities but that says to me that rheumatoid and psoriatic arthritis are different auto-immune diseases,
     
    Differential diagnosis of them is not always easy but the presence of a protein called rheumatoid factor in the blood is often indicative of rheumatoid arthritis but not psoriatic arthritis - a simple blood test can show this - your rheumatologist should be able to tell you more about this.
     
    You might find the information in these links helpful:
     
    http://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/basics/definition/con-20015006
     
    http://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/basics/definition/con-20014868
     
    I suggest that you have a look at them - that knowledge should help you to ask your rheumatologist good questions about possible treatment the next time you see him/her.

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    Thanks

    Dr Irwin Lim

    Rheumatologist

    Irwin has been a rheumatologist in Sydney since 2003. He is a co-founder and medical director of BJC Health, which consists of a team of … View Profile

    For a long time, RA and PsA (psoriatic arthritis) were treated very similarly and often those with seronegative rheumatoid arthritis may actually have been better classified as having PsA.

    While this was a little academic in previous years because the treatments used were pretty similar, the last decade has really highlighted that these are quite different diseases, with the abnormalities in signalling chemicals and the autoimmune abnormalities being different.

    This new understanding has helped people develop different treatments specific to the different diseases.

    There have been many advances in understanding PsA recently and this is set to continue.

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