Confusable diagnoses · PANCE / PANRE

Osteoarthritis vs Psoriatic Arthritis

Osteoarthritis and Psoriatic Arthritis are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.

Osteoarthritis vs Psoriatic Arthritis at a glance

  • Osteoarthritis: Non-inflammatory degenerative joint disease driven by progressive articular cartilage loss.
  • Psoriatic Arthritis: Seronegative inflammatory arthritis associated with psoriasis; classic features include dactylitis, enthesitis, and DIP involvement.
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Side-by-side comparison

FeatureOsteoarthritisPsoriatic Arthritis
At a glanceNon-inflammatory degenerative joint disease driven by progressive articular cartilage loss.Seronegative inflammatory arthritis associated with psoriasis; classic features include dactylitis, enthesitis, and DIP involvement.
Classic presentationHeberden nodes (DIP) and Bouchard nodes (PIP); squared first CMC joint; medial knee joint-line tenderness.; Insidious joint pain worse with activity and…Joint pain with morning stiffness >30 minutes, improving with activity; Asymmetric oligoarthritis (most common pattern), DIP-predominant, polyarticular…
Workup / key labsACR clinical criteria for knee OA: knee pain plus at least 3 of: age >50, stiffness <30 min, crepitus, bony tenderness, bony enlargement, no palpable warmth.…CASPAR classification criteria: inflammatory articular disease (joint, spine, or entheseal) plus ≥3 points from psoriasis, nail changes, RF-negative,…
ImagingWeight-bearing plain radiographs of the affected joint — first-line; MRI reserved for atypical presentations, suspected meniscal or ligamentous injury, or…Plain radiographs — 'pencil-in-cup' deformity at DIPs, periostitis, fluffy new bone formation, marginal erosions, ankylosis, asymmetric sacroiliitis,…
First-line treatmentPatient education and self-management programs; Exercise: low-impact aerobic, strengthening (quadriceps for knee OA), aquatic therapy; Weight loss (5-10% body…Mild peripheral disease: NSAIDs — naproxen, ibuprofen, meloxicam — plus intra-articular steroid injections; Conventional DMARDs for peripheral arthritis:…

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Educational use only. This outline is a study aid for PA students and is not medical advice or a substitute for clinical judgment. FirstPassPA is an independent study tool and is not affiliated with, endorsed by, or sponsored by NCCPA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants.