Artrite psorisiaca diagnosi, rischi e cure possibili

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Una piccola percentuale di persone con artrite psoriasica può sviluppare una forma grave, dolorosa e invalidante della malattia: l’artrite mutilante, capace di distruggere le piccole ossa delle mani, soprattutto le dita, con conseguente deformazione permanente e disabilità. E’ molto importante dunque fare una diagnosi quanto più precoce possibile dell’artrite psorisiaca con lo scopo di avviare la terapia e prevenire complicazioni.

artrite psorisiaca diagnosi cure rischi

Come si fa la diagnosi dell’artrite psorisiaca?

Un primo passo per la diagnosi di questa malattia autoimmune è sicuramente la visita clinica: il medico esamina le articolazioni per i sintomi dolorosi e di gonfiore, controlla le unghie per verificare la presenza di psoriasi, controlla il gonfiore sulle piante dei piedi ed i talloni. Non esiste un test specifico per diagnosticare l’artrite psorisiaca, ma alcune indagini diagnostiche sono comunque utili e significative per escludere altre cause di dolore alle articolazioni, come l’artrite reumatoide e la gotta. Tra queste troviamo:

  • Raggi X (che possono identificare alterazioni delle articolazioni tipiche dell’artrite psorisiaca, ma non di altre forme di artrite
  • Risonanza Magnetica (può evidenziare prblemi ai tendini o ai legamenti dei piedi o della schiena)
  • Esami del sangue ( tra cui la ricerca del Fattore Reumatoide (RF) , un anticorpo speso presente nel sangue di chi soffre di artrite reumatoide, ed assente in caso di quella psorisiaca)
  • Test del liquido sinoviale (si rimuove con un ago del liquido dalle articolazioni, colpite: se si trovano cristalli di acido urico si tratta di gotta).

 

Cure e farmaci

Non esiste una cura per l’artrite psoriasica, per cui il trattamento si concentra sul controllo dell’infiammazione alle articolazioni colpite per prevenire il dolore e la disabilità.

I medicinali utilizzati in caso di artrite psoriasica includono:

  • FANS. Farmaci anti-infiammatori non steroidei (FANS) -alleviano il dolore e riducono l’infiammazione.
  • Farmaci antireumatici modificanti la malattia (DMARD). Rallentano la progressione della malattia e prevegono danni alle articolazioni. Possono avere però severi effetti collaterali.
  • Immunosoppressori. Questi farmaci agiscono sul sistema immunitario impazzito (tale condizione rientra tra le malattie autoimmuni). Tra questi troviamo l’azatioprina (Imuran, Azasan) e la ciclosporina (Gengraf, Neoral, Sandimmune). Tra gli effetti collaterali un aumentato rischio di incappare in infezioni.
  • Inibitori del TNF-alfa. Il Fattore di necrosi tumorale alfa (TNF-alfa) è una sostanza infiammatoria prodotta dall’organismo. Tali farmaci inibitori possono aiutare a ridurre il dolore, la rigidità mattutina, e/o il gonfiore delle articolazioni. Gli esempi includono: etanercept (Enbrel), Infliximab (Remicade), Adalimumab (Humira), golimumab (Simponi) e Certolizumab (Cimzia). Potenziali effetti collaterali includono nausea, diarrea, perdita di capelli e un aumento del rischio di infezioni gravi.
  • Iniezioni di steroidi. Tale metodica riduce l’infiammazione in modo rapido e localizzato.

In taluni casi estremi, quando il danno alle articolazioni è ormai determinato, si può infine ricorrere ad interventi chirurgici di sostituzione dei giunti stessi, con protesi artificiali di metallo e plastica.

 

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Fonte: Mayo Clinic

Foto: Thinkstock

 

 

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