Psoriatic arthritis (PA) is a type of arthritis that occurs along with psoriasis in an estimated 10 – 30% of cases. Psoriasis, on the other hand, is a skin condition that causes patches of skin to become red and scaly and can be treated conservatively. Symptoms of both psoriasis and PA may come and go called flare-ups and remission. These chronic conditions can and often worsen over time.
PA usually develops after skin symptoms, but it is possible for symptoms of arthritis to occur first. The most common symptoms are joint pain, stiffness and swelling. Typically the onset of arthritis is about 10 years after the skin condition develops, so the typical age it is diagnosed is between 30 and 50 years old.
PA symptoms may occur in different ways, and individuals may experience all of them during the course of their condition. Pain may occur on only one side of the body, on both sides of the body at the same time, in the finger joints and in the spine. Psoriasis with nail lesions is the greatest risk factor for developing PA. Another large role with PA is family history and that may determine any future risk. PA occurs in men and women equally but the specific types of arthritis may differ between men and women.
PA may be difficult to diagnose precisely without specific tests: including x-rays and joint fluid samples, to determine what might be causing symptoms. Sedimentation rate is a blood test that measures how far and quickly red blood cells fall from the top of a glass tube during an hour. Inflammation causes a higher Sedimentation rate and may or may not be a sign of PA. The measure of a rheumatoid factor is an immunity protein that is present with rheumatoid arthritis, but not PA, helping doctors distinguish between the two.
Social Security considers the effects of PA as it does any other medical or mental impairment. PA is a severe impairment if it prevents a person from working for twelve continuous months or more or will result in death.
If a person does not specifically meet or equal the listing criteria and severity of the PA impairment listing (14.09), they may still be approved for disability benefits. Social Security has another method of approving individuals for disability. If a person is unable to work because of the limitations of PA, they may be approved for disability through a medical vocational allowance.
Social Security disability examiners are able to consider a person’s residual functional capacity (what they are able to do in spite of limitations), age, education, past work activity and their ability to perform other types of work when their limitations are considered. If the disability examiner finds that their residual functional capacity is so restrictive it precludes their past work or jobs or any other work, they may be approved for disability benefits.
A rheumatologist is always the best avenue and I also recommend that a person with PA keep a diary regarding flares and symptoms. The diary should be given to the doctor at each visit to insure proper treatment.