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The early warning signs of psoriatic arthritis (PsA) can be hard to spot. Any delay in diagnosis of PsA can leave patients uncomfortable and in pain. But slow diagnosis is all too common, according to Professor Laura Coates. She is leading a new study called HPOS, that is looking for 2000 UK volunteers to chart their psoriasis symptoms, and which may help to explain why one third of psoriasis patients to go on to develop arthritis.

Psoriatic arthritis HPOS study

Jayne Moggridge, who lives in Banbury, Oxfordshire knows only too well the impact a late diagnosis can have. She had mild psoriasis on her scalp for a few years but recently went on to develop PsA. Her story shows how failure to recognise and treat the condition early has left her in pain and severely impacted her quality of life.

An active mother of two young children, Jayne played football for a hobby. She suffered an injury to her foot while playing in June 2022, and after just a month, when the injury had healed, she returned to the game. However, another ankle injury forced her to hang up her boots in August. She started to walk with a slight limp but by January 2023 her foot was badly swollen, and she was in intense pain that had started to spread to all her other joints.

Doctors initially diagnosed Jayne's condition as Complex Regional Pain Syndrome (CRPS) and she was referred for physiotherapy on three occasions. They tried massage to calm the pain and swelling and at one point she was given strong anti-inflammatory tablets, but Jayne found herself in excruciating pain all the time. 'I was walking with a funny limp and when I was in a flare up I had to use a stick as well,' she said. 'On 1st March 2023 I saw a new doctor at the Nuffield Orthopaedic Hospital who diagnosed my condition as psoriatic arthritis (PsA).'

Her second visit was to see Dr Laura Coates, an NIHR Clinical Scientist and Senior Clinical Research Fellow at the University of Oxford who specialises in PsA research. 'Failure to pinpoint PsA early can lead to unnecessary pain and lower quality of life,' said Laura, who is leading the HPOS study alongside the National Institute for Health and Care Research (NIHR) and funded by the Innovative Medicines Initiative. 'We're looking for 2000 volunteers in the UK and Ireland who have psoriasis, but who haven't yet got symptoms of psoriatic arthritis. By following their psoriasis journey and any symptoms of arthritis we aim to be able to predict in future which patients are at greater risk of developing PsA and possibly do something to prevent it.'

After receiving her diagnosis Jayne's treatment plan changed. 'I was given steroid injections in March and April 2023 and was prescribed methotrexate tablets. I had another bad flare up in July which affected my feet, joints and tendons and made it hard to walk, so I was given another steroid injection to help with the pain.'

Psoriasis runs in Jayne's family and that could be one of the markers identified by the HPOS study. The research team is looking for patients with psoriasis, but who aren't yet showing signs of PsA, to sign up and join the web-based study at They will complete online questionnaires at 6-month intervals to see how their condition changes over time.

Laura said: 'If we can predict who's going to get PsA we'll be able to warn people ahead of time. We'll be able to screen people effectively so we can diagnose it quickly and get them on treatment as soon as possible, and we may even in future be able to prevent PsA.'

An earlier diagnosis and treatment would have helped Jayne who said she would encourage everyone to take part in the HPOS study. 'In my case first I had fairly mild psoriasis, then I started to get muscle aches and it just got worse from there. If the condition was caught sooner and treatment started earlier, maybe there would have been a difference in how bad it got.'

Participating in health research helps develop new treatments, improve the NHS, public health and social care and save lives.

The NHS, public health and social care supports research by giving patients opportunities to take part in trials. Healthy people can also take part so results can be compared to those with a medical condition.

Patients are also encouraged to ask their doctor or health professional about research opportunities and view and sign up to be notified about trials seeking volunteers at