9 Reasons Why a Diagnosis Can Take So Long

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Early diagnosis is critical for psoriatic arthritis. Unfortunately, diagnosing psoriatic arthritis can take a long time and may lead to feelings of frustration. Read ahead to learn about the multiple reasons why psoriatic disease might take longer to diagnose than other diseases.


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Your general practitioner is the gatekeeper

Your general practitioner (GP) is usually the first line of contact when you are sick. If your doctor suspects your condition is serious and beyond his area of expertise, he will refer you to a specialist like a rheumatologist. However, depending on the severity of the symptoms and the knowledge of your GP, you may not get a quick referral to a specialist. This can delay an accurate diagnosis of your condition.


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Your symptoms can change in severity

Symptoms of psoriatic arthritis can come and go. One day you can feel like running a road race and the next day you may not be able to put your shoes on. The times when the condition is at its worst is called a flare-up. It is not uncommon to make a doctor’s appointment during a flare-up, but then cancel the appointment if you feel better before the appointment. It may then take some time before your next flare-up and a new doctor’s appointment.


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There is no definitive test

Unlike some of the other immunology diseases, there is no definitive test for psoriatic arthritis according to the National Psoriasis Foundation. The diagnosis of psoriatic arthritis is often made by a process of elimination. This can take months of trial and error to rule out other potential causes of joint pain.


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You may not hurt in the same place all the time

A few years prior to my psoriatic arthritis diagnosis, I had visited my doctor due to a variety of joint pains. It seemed like I would call the doctor about one joint, but by the time of the appointment, a different joint would be hurting. At each appointment, we focused on the joint that was bothering me. It was not until I got my diagnosis, that I realized the different joint pains were most likely all related to my psoriatic arthritis.


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Symptoms may mimic other diseases

The symptoms of psoriatic arthritis can be similar to other joint diseases such as osteoarthritis, rheumatoid arthritis, and gout. Osteoarthritis is the most common cause of joint pain. It is understandable that if you visit your doctor with a sore joint, the immediate assumption may be that you have osteoarthritis. Rheumatoid arthritis can also present at any age, and symptoms may also come and go similarly to psoriatic arthritis. Gout can also attack any joint in your body.


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X-rays may not help

X-rays are often the first diagnostic tool your doctor may use if you report a sore joint. However, in the beginning of the disease, x-rays may not show any changes to the joints that are bothering you. Early inflammation changes that affect soft tissue will most likely not be detected with the use of a plain x-ray. Only as the disease progresses, will you be able to detect changes in the bony structures.


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Your skin symptoms may not be present

Skin symptoms of psoriasis usually develop several years before psoriatic arthritis appears. However, in about 15 percent of cases, arthritis can show up before skin changes. Therefore, your doctor may not suspect psoriatic arthritis because you are not presenting with psoriasis symptoms. You may also have experienced skin symptoms in the past, but your symptoms might be in remission when you see your doctor.


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It may take a variety of treatments

If a doctor suspects you have psoriatic arthritis, he may start a treatment that does not work on your symptoms. You might then be tempted to think that your condition is misdiagnosed and change directions thinking that you do not have psoriatic arthritis. However, it often takes multiple attempts at treatment, so it is possible that the diagnosis is correct, but an effective treatment has not yet been found.


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Your medical history may be inaccurate

My mother had psoriasis and she probably also had psoriatic arthritis. However, back in the day, her sore and swollen joints were blamed on rheumatoid arthritis. Today, thanks to advocacy work, patients and doctors are becoming more aware of psoriatic arthritis. If either of my sons develops sore joints, they will be able to tell their doctor that their mother lived with psoriatic arthritis which may help them get to a quicker diagnosis.


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Once diagnosed, get treated

If a doctor suspects you have psoriatic arthritis, he may start a treatment that does not work on your symptoms. You might then be tempted to think that your condition is misdiagnosed and change directions thinking that you do not have psoriatic arthritis. However, it often takes multiple attempts at treatment, so it is possible that the diagnosis is correct, but an effective treatment has not yet been found.