Psoriatic arthritis

Psoriatic arthritis is a form of arthritis (joint inflammation) that can occur in people who have the skin disease psoriasis. Psoriasis is a common condition characterized by scaly red and white skin patches.

Psoriatic arthritis can affect any joint in the body, including the spine. 

Psoriatic arthritis causes pain, stiffness, and swelling of the joints. It is often mild, but can sometimes be serious and affect many joints.

Your doctor will do a physical exam and imaging tests to diagnose psoriatic arthritis. There is no cure, but medicines can help control inflammation and pain. In rare cases, you might need surgery to repair or replace damaged joints.

The cause of psoriatic arthritis is not known; however, doctors believe a combination of genetic and environmental factors is involved. Research shows that people with psoriatic arthritis often have a family member with psoriasis or arthritis. In people who are susceptible, an infection may activate the immune system, triggering the development of psoriatic arthritis.

Musculoskeletal symptoms may include

  • Joint pain and swelling that may come and go and may be accompanied by redness and warmth.
  • Tenderness where muscles or ligaments attach to the bones, particularly the heel and bottom of the foot.
  • Inflammation of the spinal column, called spondylitis, which can cause pain and stiffness in the neck and lower back.
  • Morning stiffness.
  • Reduced range of motion of the joints.
  • Painful, sausage-like swelling of the fingers and/or toes.

Skin symptoms may include

  • Thickness and reddening of the skin with flaky, silverwhite patches, called scales.
  • Pitting of the nails or separation from the nail bed.

Other symptoms may include

  • General fatigue and malaise.
  • Conjunctivitis (also known as pink eye), inflammation, or infection of the membrane lining the eyelid and part of the eyeball.

The diagnosis of psoriatic arthritis is made based on the findings of a medical and family history and physical exam as well as x-ray or magnetic resonance imaging (MRI) of the affected joints. Although there is no lab test to diagnose psoriatic arthritis, your doctor may order tests on blood or joint fluid to rule out other forms of arthritis with similar symptoms. If you have psoriasis and start to develop joint pain, it’s important to see your doctor. Early diagnosis and treatment of psoriatic arthritis can help prevent irreparable joint damage.

Treatment for psoriatic arthritis will depend largely on its severity. If the disease is mild and affects only a couple of joints, treatment with nonsteroidal antiinflammatory drugs (NSAIDs) may be sufficient for treating pain and inflammation. For acutely inflamed joints, corticosteroid injections may be helpful. For more persistent disease affecting multiple joints, stronger disease-modifying antirheumatic drugs (DMARDs) and/or antitumor necrosis factor (TNF) agents may be needed to control the disease.