Psoriatic Arthritis Blood Test: Types, How to Prepare (2022)

There is no single blood test that can check for psoriatic arthritis (PsA), a chronic, inflammatory disease of the joints that can also cause a skin disorder called psoriasis. Your doctor will order a series of blood tests to check for different signs of psoriatic arthritis. This means diagnosis will take more than a single visit.

While you might be tempted to rely on your doctor to monitor your condition through blood tests, you may find it’s helpful to have a basic understanding of what is being tested and why. This way, you’ll know which questions to ask to get the best treatment possible.

Psoriatic Arthritis Blood Test: Types, How to Prepare (1)

Types of Blood Tests

The specific types of blood tests your doctor will order may vary. Only after reviewing the results of these tests together, along with your symptoms, will your doctor make a diagnosis.

When it comes to inflammatory illnesses like PsA, the tests are typically checking for signs of inflammation in your blood. Doctors call these “biomarkers” of inflammation.

Following are the common blood tests for arthritis:

  • Antinuclear antibody test (ANA): This is a basic blood test that can tell whether your body’s white blood cells are making higher levels of antibodies. A positive ANA test doesn’t necessarily mean you have an autoimmune disorder.
  • Erythrocyte sedimentation rate (ESR, also called sed rate): Sed rate checks for inflammation and can be used to track progression of inflammatory diseases. An increased sed rate may indicate inflammation, but it can also be due to other conditions.
  • C-reactive protein (CRP): This general blood test checks for the C-reactive protein and indicates the presence or absence of inflammation.
  • Rheumatoid Factor (RF): If your rheumatoid factor is high, it could mean you have an autoimmune disease like PsA or rheumatoid arthritis. About 80% of rheumatoid arthritis patients have the rheumatoid factor in their blood.
  • Human leukocyte antigen B27 (HLA-B27): This checks for the HLA-B27 protein on your white blood cells, which can show increased activity in disease states.
  • Serum uric acid measurement: This tests uric acid levels (waste products) found in your blood and determines how well your body produces and then removes uric acid. Uric acid is made when your body breaks down purines from foods. High uric acid levels could indicate a type of arthritis called gout.

Learn About What Blood Tests Reveal in Arthritis

Other Tests for Psoriatic Arthritis

You will likely also be required to take the following tests for your diagnostic examination to be considered complete:

  • Bone density scans can check for joint damage or bone loss and look for other conditions like osteoporosis (weak bones), osteopenia (weak bones not quite as severe as osteoporosis), and demineralized bones (loss of calcium in bones).
  • Imaging tests like X-rays and MRIs (magnetic resonance imaging tests)are used to examine bones and joints in detail to see the level of damage or inflammation.

Why Have an X-Ray or MRI?

X-rays and MRIs can show signs or features of psoriatic arthritis. These include:

(Video) Why are regular blood tests necessary for Psoriatic Arthritis?

  • Asymmetric joint involvement, with joint changes on one side, as opposed to symmetrical, or both-sided, joint involvement with rheumatoid arthritis
  • Distal joint involvement, including changes in the joints closest to the nail of the fingers or toes
  • Entheseal involvement, meaning "insertion" in Greek, "entheseal" here refers to any attachment site like a tendon or ligament to a bone
  • Asymmetrical spinal involvement, a curvature to one side of the spine, as opposed to the symmetrical involvement in the autoimmune disease ankylosing spondylitis
  • Pencil-in-cup deformity, when the finger looks like a sharpened pencil and the adjacent bone has been worn down into a cup-like shape

Treatment Procedures

Your primary care doctor will order blood work, sending the lab request to the closest or most convenient clinic covered under your insurance plan. Your doctor may also ask you to get an imaging test.

Due to the nature of these blood and imaging tests, all of them require in-person visits. Follow-ups, however, may be handled either in person or through telehealth appointments (by way of video or audio visits in your home), especially when reviewing test results, renewing prescriptions, or doing general check-ins after you have your diagnosis.

Your Appointment

On the day of your appointment, you will have a laboratory technician, such as a phlebotomist, nurse, or other trained medical professional, draw blood from your arm. This is the person who will label your vials and either test them on-site or send them to a laboratory for assessment.

If the tests show markers of inflammation and you are experiencing other symptoms of psoriatic arthritis (like psoriasis flare-ups, including itchy, scaly skin, and joint pain), you will be referred to a specialist called a rheumatologist.

What Is a Rheumatologist?

A rheumatologist is a specialist in the nonsurgical treatment ofautoimmune, inflammatory, or other musculoskeletal conditions commonly referred to as rheumatic diseases.

Your rheumatologist is the best person to:

  • Confirm your diagnosis after reviewing all test results and your medical history
  • Direct you toward the best treatment depending on the severity of your psoriatic arthritis and whether the symptoms are mostly external (skin issues), internal (joint issues), or a combination of both.

What Is a Rheumatologist?

How to Prepare

Getting blood work usually is straightforward, but there are a few steps you can take to make sure the experience goes as smoothly as possible. If you're allowed to drink water, keep yourself as hydrated as possible prior to the blood draw.

Some of the most common factors to consider before getting blood work include:

  • Verifying if you need to fast (abstain from food or drink) for any of the tests ordered
  • Reviewing with your physician your medications, including any vitamins, supplements, herbs, and drugs, in case they can affect test outcomes
  • Thoroughly reading your patient care instructions
  • If you struggle with medical, needle, or blood phobias, asking your doctor for advice on coping strategies and whether you can bring a support person to the clinic
  • Asking questions or if there’s anything else you should be aware of before leaving your appointment

Unless you are told to do so, don’t make major dietary changes before getting blood work. Doing so could compromise the quality of the results, including by affecting comparisons between past and current results.

What’s Considered Healthy?

Your medical provider will go over your labs after results are available. The results should indicate ideal levels of certain inflammatory markers and also what you tested at.

Many of the items listed are in shorthand, so ask your doctor to go over your results with you. Because many tests do not definitively confirm you have psoriatic arthritis, additional steps are necessary, including follow-up visits and additional blood work.

(Video) Psoriatic Arthritis

A Word From Verywell

If your doctor has suggested blood testing to see if you have psoriatic arthritis, you may be surprised to learn there is no single test for this inflammatory condition. Rather, there are several important tests to check for levels of inflammation and for certain proteins in your blood that may indicate PsA.

Getting blood work, as well as imaging tests, will help your doctor diagnose your condition and find the most effective treatments available.

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

(Video) Diagnosing and managing psoriatic arthritis

  1. Brenner DR, Scherer D, Muir K, et al. A review of the application of inflammatory biomarkers in epidemiologic cancer research.Cancer Epidemiol Biomarkers Prev. 2014;23(9):1729-1751. https://doi.org/10.1158/1055-9965.EPI-14-0064

  2. American College of Rheumatology. Antinuclear antibodies.

  3. Cleveland Clinic. Sed rate (erythrocyte sedimentation rate).

  4. Ingegnoli F, Castelli R, Gualtierotti R. Rheumatoid factors: clinical applications. Dis Markers. 2013 Nov 13;35(6):727-34. https://doi.org/10.1155/2013/726598

  5. Arthritis Foundation. Psoriatic Arthritis.

  6. Tiwari V, Brent LH. Psoriatic arthritis. In:StatPearls. StatPearls Publishing.

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By Michelle Pugle
Michelle Pugle, BA, MA, is an expert health writer with nearly a decade of contributing accurate and accessible health news and information to authority websites and print magazines. Her work focuses on lifestyle management, chronic illness, and mental health. Michelle is the author of Ana, Mia & Me: A Memoir From an Anorexic Teen Mind.

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FAQs

How are you tested for psoriatic arthritis? ›

To diagnose psoriatic arthritis, rheumatologists look for swollen and painful joints, certain patterns of arthritis, and skin and nail changes typical of psoriasis. X-rays often are taken to look for joint damage. MRI, ultrasound or CT scans can be used to look at the joints in more detail.

Can a blood test tell if you have psoriatic arthritis? ›

There is no single blood test that can check for psoriatic arthritis (PsA), a chronic, inflammatory disease of the joints that can also cause a skin disorder called psoriasis. Your doctor will order a series of blood tests to check for different signs of psoriatic arthritis.

What type of doctor do you see most often for your psoriatic arthritis? ›

Rheumatologists and dermatologists generally have the most experience diagnosing and treating psoriatic arthritis. If you are diagnosed with psoriatic arthritis, it is important to know that treatment can: Ease swelling, pain, stiffness, and other symptoms.

What organs does psoriatic arthritis affect? ›

You'll probably think of skin issues first, but your eyes, heart, lungs, gastrointestinal (GI) tract (stomach and intestines), liver and kidneys may also be affected. Skin. Psoriasis appears first in 60% to 80% of patients, usually followed within 10 years — but sometimes longer — by arthritis.

Can I have psoriatic arthritis without psoriasis? ›

Answer: Yes, it is certainly possible to have PsA with no psoriasis/skin symptoms. For the majority of people with PsA, psoriasis precedes the onset of arthritic symptoms, but some people develop the skin disease after the onset of arthritis. So, there may be a period of arthritis without psoriasis.

Where does psoriatic arthritis usually start? ›

PsA may begin in smaller joints, such as those of the fingers or toes, and progress from there. Spondylitis may be accompanied by dactylitis, or swelling of the toe or finger joints. This is sometimes called “sausage fingers.”

What triggers psoriasis arthritis? ›

The cause of psoriatic arthritis is unknown. Researchers suspect that it develops from a combination of genetic (heredity) and environmental factors. They also think that immune system problems, infection, obesity, and physical trauma play a role in determining who will develop the disease.

What is the safest drug for psoriatic arthritis? ›

What Is the Safest Drug for Psoriatic Arthritis?
  • Over-the-counter (OTC) Ibuprofen (Advil, Motrin) Naproxen (Aleve) Aspirin.
  • Prescription. Celecoxib (Celebrex)
21 Jul 2021

Is psoriatic arthritis worse than rheumatoid? ›

A study published in 2015 in the journal PLoS One found that the overall pain, joint pain, and fatigue reported by psoriatic arthritis patients was significantly greater than that reported by people with rheumatoid arthritis.

What are the six signs of psoriatic arthritis? ›

Here are six symptoms you should watch out for.
  • It's hard to move in the morning. ...
  • Your fingers look like warm sausages. ...
  • You have lower back pain. ...
  • Your nails have grooves and ridges. ...
  • You experience eye problems. ...
  • You're always tired.
22 Jul 2021

How high is CRP in psoriatic arthritis? ›

CRP was significantly elevated (>5 mg/L) in psoriatic patients when compared with controls (52% vs 14%) (P = 0.001). Psoriatic patients with severe disease (PASI > 10) showed significantly higher levels of CRP than those with mild disease (PASI < 10) (44% vs 25%, P value = 0.003).

What is the most common type of psoriasis? ›

Plaque psoriasis.

The most common type of psoriasis, plaque psoriasis causes dry, itchy, raised skin patches (plaques) covered with scales. There may be few or many. They usually appear on the elbows, knees, lower back and scalp.

Does a rheumatologist help with psoriasis? ›

For people with psoriasis, PsA, or both, this can mean two important reasons to see a rheumatologist. For one, psoriasis that has developed into PsA requires treatment from a rheumatologist to treat the underlying causes of the inflammation that are now affecting your joints.

Does psoriatic arthritis affect the brain? ›

If you have an autoimmune disorder like psoriatic arthritis, you're also at higher risk for neurological and psychiatric conditions. Experts think this may be because the inflammation that causes your skin and joint symptoms can also affect your brain and nervous system.

How serious is psoriatic arthritis? ›

It typically causes affected joints to become swollen, stiff and painful. Like psoriasis, psoriatic arthritis is a long-term condition that can get progressively worse. If it's severe, there's a risk of the joints becoming permanently damaged or deformed, and surgery may be needed.

Does psoriatic arthritis increase Covid risk? ›

Psoriatic arthritis is a heterogeneous chronic inflammatory disease characterized by the association of psoriasis and arthritis. Similar to those with other viruses, patients with psoriatic arthritis are at a significant risk of infection with severe acute respiratory syndrome coronavirus 2.

Can the Covid vaccine give you psoriasis? ›

Besides worsening of pre-existing psoriatic lesions, a de novo generalized pustular psoriasis following administration of the first dose of AstraZeneca-Oxford COVID-19 vaccine was also reported (10). Recently, Ricardo et al. reported de novo nail psoriasis triggered by Pfizer-BioNTech in a 76-year-old woman (13).

Do you itch with psoriatic arthritis? ›

These patches can be dry, itchy, and sore. The rash can develop anywhere, but it often affects the following parts of the body: elbows. knees.

What is the best pain medication for psoriatic arthritis? ›

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Your doctor might first recommend treating your psoriatic arthritis pain with ibuprofen (Motrin, Advil), or naproxen (Aleve). These drugs relieve pain and ease swelling in the joints. You can buy NSAIDs over the counter. Stronger versions are available with a prescription.

How fast does psoriatic arthritis progress? ›

The majority of cases begin with the skin condition and then progress to joint pain within seven to 10 years. “Recent studies have found that patients with psoriasis who develop severe fatigue, heel pain, and joint pain without overt swelling are more likely to develop PsA.”

How long does it take to become disabled with psoriatic arthritis? ›

It typically takes more than 3 months to receive a decision, but it can take up to 2 years in some cases. You can begin the process by filling out an online application, calling Social Security, or visiting your local Social Security office.

What psoriatic arthritis feels like? ›

Psoriatic arthritis causes joint pain, swelling, and stiffness. Psoriatic arthritis pain is described as worse in the morning or after resting, tender, throbbing, warm to the touch, and exhausting. It primarily affects the knees and ankles, but can also occur in the neck, lower back, hips, shoulders, heels, and feet.

What organs can be affected by psoriasis? ›

This autoimmune disease causes your connective tissue and skin to harden and tighten. It can affect your digestive tract and organs, such as the heart, lungs, and kidneys. It's also called systemic scleroderma. Inflammatory bowel disease.

What foods to avoid if you have psoriatic arthritis? ›

Foods like fatty red meats, dairy, refined sugars, processed foods, and possibly vegetables like potatoes, tomatoes, and eggplants (you might hear them called nightshades) may all cause inflammation. Avoid them and choose fish, like mackerel, tuna, and salmon, which have omega-3 fatty acids.

Does psoriatic arthritis make you gain weight? ›

When someone has PsA, painful joints can make exercise difficult, contributing to weight gain. This places even more pressure on the joints and can make symptoms, such as pain and stiffness, worse. Being overweight can increase inflammation and may stop some PsA medications from working as well as they should.

What is the newest treatment for psoriatic arthritis? ›

The US Food and Drug Administration (FDA) has approved risankizumab-rzaa (skyrizi) for the treatment of active psoriatic arthritis (PsA) in adults.

What is the new pill for psoriasis? ›

Otezla® (apremilast) is a prescription medicine used to treat adult patients with: Plaque psoriasis for whom phototherapy or systemic therapy is appropriate.

Can psoriatic arthritis affect your teeth? ›

People with psoriatic arthritis, like those with rheumatoid arthritis, are prone to tooth and gum problems. You're more than twice as likely as other people to have inflammation of the gums and poor dental health has been linked to higher rates of heart disease.

Can you go on disability for psoriatic arthritis? ›

Psoriatic arthritis falls under the classification of immune system impairments of the Disability Evaluation Under Social Security. 2 More specifically, it is listed under section 14.09 titled “Inflammatory Arthritis.” If someone meets the requirements under section 14.09, they may be approved for disability payments.

Does psoriatic arthritis affect your eyes? ›

People with PsA may develop eye conditions that cause symptoms such as: red eyes. itchy eyes. dry eyes or feeling of grit or sand in the eyes.

What is the difference between arthritis and psoriatic arthritis? ›

Osteoarthritis happens when cartilage in your joints wears away over time. In contrast, psoriatic arthritis is an autoimmune disease. It happens when your immune system mistakenly views healthy cells as a threat and attacks them. Psoriatic arthritis can affect your skin, nails, and joints.

What does the beginning of psoriatic arthritis look like? ›

Stiff, puffy, sausage-like fingers or toes are common, along with joint pain and tenderness. The psoriasis flares and arthritis pain can happen at the same time and in the same place, but not always. You may also notice: Dry, red skin patches with silvery-white scales.

Is psoriatic arthritis hereditary? ›

Psoriatic arthritis (PsA) is an inflammatory arthritis that manifests in 20–30% of patients diagnosed with psoriasis1. PsA is attributed to genetic, immunologic, and environmental factors2, and epidemiologic studies suggest a strong genetic basis to PsA.

What can mimic psoriatic arthritis? ›

Other conditions that can mimic or have similar symptoms as psoriatic arthritis include axial spondyloarthritis, enteropathic arthritis, gout, osteoarthritis, plantar fasciitis, reactive arthritis, and rheumatoid arthritis.

What is a normal sed rate for psoriatic arthritis? ›

According to the Mayo Clinic, a healthy sedimentation rate generally ranges from 0 to 22 mm/hour for males and 0 to 29 mm/hour for females. Around 40 percent of people with psoriatic arthritis exhibit elevated ESR rates.

Can psoriatic arthritis cause high protein levels? ›

C-reactive protein (CRP) is an important non-specific marker of both acute and chronic inflammation and can be elevated in patients with psoriatic arthritis (PsA).

Does psoriatic arthritis show up on xray? ›

Psoriatic arthritis is diagnosed using radiological imaging. Doctors commonly use X-ray, ultrasound, and MRI to aid in the diagnosis of the condition, and if needed, they will employ other imaging techniques, including CT and bone scans.

Can psoriasis cause lower back pain? ›

Summary. Psoriatic arthritis is an inflammatory form of arthritis that develops in some people with psoriasis, an autoimmune skin disease that causes skin cells to build up and form plaques. The condition can affect the lumbar spine, or lower back, and cause pain in the area.

When does psoriatic arthritis develop? ›

Signs and symptoms

It most often starts in those aged 15 to 30, with psoriatic arthritis commonly developing between the ages of 25 and 50. However, both conditions can start at any age. In about one in five cases, joint problems are diagnosed before any obvious signs of psoriasis.

Can psoriasis affect your brain? ›

Psoriasis affects your brain chemicals.

These make skin cells grow out of control and form scaly plaques. They also change levels of chemicals in your brain that affect your mood. A cytokine called TNF-alpha may affect brain chemicals like serotonin in a way that could lead to depression.

What are the 7 types of psoriasis? ›

Types of Psoriasis
  • Guttate Psoriasis. Guttate psoriasis affects roughly 8 percent of people living with psoriasis. ...
  • Pustular Psoriasis. Pustular psoriasis affects about 3 percent of people living with psoriasis. ...
  • Plaque Psoriasis. ...
  • Inverse Psoriasis. ...
  • Erythrodermic Psoriasis.
10 Mar 2021

When is psoriasis considered severe? ›

If more than 10% of your body is affected, or if large areas on your face, palms or soles of your feet have patches, you have severe psoriasis.

What organs does psoriatic arthritis affect? ›

You'll probably think of skin issues first, but your eyes, heart, lungs, gastrointestinal (GI) tract (stomach and intestines), liver and kidneys may also be affected. Skin. Psoriasis appears first in 60% to 80% of patients, usually followed within 10 years — but sometimes longer — by arthritis.

How does a rheumatologist test for psoriatic arthritis? ›

To diagnose psoriatic arthritis, rheumatologists look for swollen and painful joints, certain patterns of arthritis, and skin and nail changes typical of psoriasis. X-rays often are taken to look for joint damage. MRI, ultrasound or CT scans can be used to look at the joints in more detail.

How do doctors test for psoriatic arthritis? ›

Joint fluid test.

Using a needle, the doctor can remove a small sample of fluid from one of your affected joints — often the knee. Uric acid crystals in your joint fluid might indicate that you have gout rather than psoriatic arthritis. It's also possible to have both gout and psoriatic arthritis.

Are inflammatory markers raised in psoriatic arthritis? ›

Background CRP and ESR are the most commonly and probably the most studied inflammatory markers among patients with inflammatory arthritis. In contrast to rheumatoid arthritis, however, these markers are raised in less than 50% of people with psoriatic arthritis (PsA).

What are the six signs of psoriatic arthritis? ›

Here are six symptoms you should watch out for.
  • It's hard to move in the morning. ...
  • Your fingers look like warm sausages. ...
  • You have lower back pain. ...
  • Your nails have grooves and ridges. ...
  • You experience eye problems. ...
  • You're always tired.
22 Jul 2021

Does positive ANA mean psoriatic arthritis? ›

Here, we wondered whether antinuclear antibodies could be of some help in diagnosing psoriatic arthritis. We found that, if one sets positivity at a titer of 1:160, more than half of the patients with psoriatic arthritis and less than a quarter of healthy controls have ANA in their sera.

What can mimic psoriatic arthritis? ›

Other conditions that can mimic or have similar symptoms as psoriatic arthritis include axial spondyloarthritis, enteropathic arthritis, gout, osteoarthritis, plantar fasciitis, reactive arthritis, and rheumatoid arthritis.

How high is CRP in psoriatic arthritis? ›

CRP was significantly elevated (>5 mg/L) in psoriatic patients when compared with controls (52% vs 14%) (P = 0.001). Psoriatic patients with severe disease (PASI > 10) showed significantly higher levels of CRP than those with mild disease (PASI < 10) (44% vs 25%, P value = 0.003).

What infections cause psoriatic arthritis? ›

Some people get psoriatic arthritis after an infection, but it's not clear which bacteria or viruses are to blame. The strep bacteria that cause sore throats could be one. A bout of strep throat or other upper respiratory infection can lead to a flare-up of symptoms. The HIV virus could also be involved.

Can psoriatic arthritis affect the brain? ›

If you have an autoimmune disorder like psoriatic arthritis, you're also at higher risk for neurological and psychiatric conditions. Experts think this may be because the inflammation that causes your skin and joint symptoms can also affect your brain and nervous system.

Where does psoriatic arthritis usually start? ›

PsA may begin in smaller joints, such as those of the fingers or toes, and progress from there. Spondylitis may be accompanied by dactylitis, or swelling of the toe or finger joints. This is sometimes called “sausage fingers.”

Is psoriatic arthritis worse than rheumatoid? ›

A study published in 2015 in the journal PLoS One found that the overall pain, joint pain, and fatigue reported by psoriatic arthritis patients was significantly greater than that reported by people with rheumatoid arthritis.

How serious is psoriatic arthritis? ›

It typically causes affected joints to become swollen, stiff and painful. Like psoriasis, psoriatic arthritis is a long-term condition that can get progressively worse. If it's severe, there's a risk of the joints becoming permanently damaged or deformed, and surgery may be needed.

Can psoriatic arthritis turn into lupus? ›

Study Finds People With Psoriatic Arthritis Have Increased Risk for Lupus. A recent study published in The Journal of Rheumatology has explored the potential link between psoriatic arthritis (PsA) and lupus. PsA often occurs alongside psoriasis, an inflammatory skin condition.

Is psoriatic arthritis worse than lupus? ›

The symptoms of psoriasis and lupus may take effect throughout the body, but they can be particularly apparent on the skin or in the joints. While psoriasis and psoriatic arthritis can be uncomfortable, they are generally less serious than lupus and may cause less severe symptoms.

Is psoriatic arthritis similar to lupus? ›

Like lupus, psoriatic arthritis happens when your immune system attacks your healthy cells and tissues. This causes your joints to get inflamed and your skin to make too many cells.

Does psoriatic arthritis qualify for disability? ›

If you have psoriatic arthritis, you may qualify for Social Security disability insurance. Your level of benefits depends on your ability to work and how long you've been paying into Social Security. You'll need a lot of documentation to make your case, but the effort is worth it.

What is the best pain medication for psoriatic arthritis? ›

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Your doctor might first recommend treating your psoriatic arthritis pain with ibuprofen (Motrin, Advil), or naproxen (Aleve). These drugs relieve pain and ease swelling in the joints. You can buy NSAIDs over the counter. Stronger versions are available with a prescription.

Does psoriatic arthritis affect muscles? ›

Psoriatic arthritis (PsA) is a chronic, inflammatory musculoskeletal disorder in people with psoriasis. Patients with PsA often complain of muscle pain and weakness. There are several reasons people with psoriatic arthritis can have muscle pain and weakness.

Videos

1. Psoriatic Arthritis Treatment | Johns Hopkins Medicine
(Johns Hopkins Rheumatology)
2. The Diagnosis and Management of Psoriatic Arthritis
(Musculoskeletal Australia)
3. Diagnosing Psoriatic Arthritis
(National Psoriasis Foundation)
4. Biologics for Psoriatic Arthritis
(Dr. April Armstrong)
5. Living Well with Psoriatic Arthritis
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6. Inflammatory Arthritis
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