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Is there imaging or other tests that can be done to assess the damage from PSA and / or distinguish the differences btwn psa and osteo

A MyPsoriasisTeam Member asked a question 💭
Orlando, FL
April 28
 · 
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A MyPsoriasisTeam Member

Hi @A MyPsoriasisTeam Member, it's my understanding that the damage caused by PsA will look very much like Osteo. It's the inflammation that sets it apart. If you weren't having a flare and went to the rheumatologist the X-ray would look like osteo despite the cause being PsA. I think this is one reason diagnosis is delayed for so many of us

April 29
MyPsoriasisTeam

Yes! There are several tests that can help assess psoriatic arthritis (PsA) damage and tell it apart from other joint conditions. Doctors typically use a combination of imaging, blood tests, and physical evaluations rather than relying on just one test.

Here's a breakdown of the main imaging options:

- X-rays – The first Show Full Answer

Yes! There are several tests that can help assess psoriatic arthritis (PsA) damage and tell it apart from other joint conditions. Doctors typically use a combination of imaging, blood tests, and physical evaluations rather than relying on just one test.

Here's a breakdown of the main imaging options:

- X-rays – The first line of imaging for both PsA and other joint conditions. More useful in later stages, they can reveal a tell-tale sign called the "pencil-in-cup" appearance, where bone damage changes the shape of the joint
- Ultrasound – Great for catching early signs of PsA, including enthesitis (inflammation where tendons/ligaments meet bone), sometimes even before it causes pain
- MRI – More sensitive than X-rays, MRI picks up soft tissue damage and inflammation earlier and in more detail
- CT scans – Also used to help measure how PsA is progressing over time Beyond imaging, these additional tests help build a fuller picture:

- Blood tests – Can detect inflammation markers like C-reactive protein and erythrocyte sedimentation rate, which are elevated when PsA is active. Importantly, these markers don't show up with joint conditions that aren't inflammatory, which helps distinguish PsA
- HLA-B27 blood test – Can help identify the cause of joint pain
- Arthrocentesis – A procedure where fluid is drawn from a swollen joint with a needle to examine its contents
- Skin biopsy – A small skin sample can confirm psoriasis, which is a strong indicator that joint symptoms may be PsA-related
- Physical/nail exam – Nail pitting, ridging, or crumbling are early PsA signs a doctor will look for

A rheumatologist is the best specialist to guide this process, as diagnosing PsA can be tricky and usually requires combining several of these approaches together.

April 28

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