Psoriatic arthritis (PsA) is a type of chronic inflammatory arthritis that can occur in about 3 of every 10 people who have psoriasis. It may cause pain, stiffness, and swelling in a person’s joints as well as skin symptoms. The underlying inflammation involved in PsA can affect the entire body. Without treatment, PsA may cause permanent joint and tissue damage.

PsA is an autoimmune disease. Normally, our body’s immune system protects us from harmful bacteria, viruses, parasites, and fungi. But when a person has an autoimmune disease, his or her immune system mistakenly attacks the body’s own tissue. With PsA, it attacks the joints and skin.

What causes PsA?

The exact cause of PsA is not yet known. Family history plays a strong role in PsA; about 40% of those with the disease have a family member with psoriasis or arthritis.

Risk factors for PsA can include obesity, severe psoriasis, nail disease, and trauma or deep lesions at sites of trauma. Psoriasis can typically precede PsA. Psoriasis is a chronic autoimmune condition that causes raised, red, scaly patches on the skin. These appear most commonly on the elbows, knees, scalp, lower back, face, palms, and soles of the feet. PsA is more common in Caucasians and typically appears in the ages between 30 and 50.

What are the symptoms of PsA?

PsA can affect any joint in the body. It can affect one joint or several joints (frequently large joints of the legs or joints at the end of fingers and toes as well as the spine and hips), fingernails, toenails, and tendons where they join onto the bone. Some of the symptoms of PsA include:

• Feeling tired.
• Swollen fingers and toes that look like sausages.
• Stiffness, pain, throbbing, swelling, and tenderness in one or more joints.
• A reduced range of motion.
• Feeling stiff and tired in the morning.
• Changes in fingernails or toenails, such as the nail separating from the nail bed or becoming pitted (small depressions on the nail surface).

The symptoms of PsA come and go and are not the same for everyone. A person may have symptoms that affect different parts of his or her body at different times. For example, some people may not have signs of skin and/or nail problems and may have only joint pain and swelling.

How is PsA diagnosed?

It can be challenging for doctors to diagnose PsA because the symptoms are similar to other types of arthritic diseases such as rheumatoid arthritis, reactive arthritis, and gout. People who have symptoms of PsA or people who have psoriasis and develop joint pain should consider seeing a type of doctor called a rheumatologist. These doctors are specialists in musculoskeletal disorders (which include the different types of arthritis), so they have more experience and expertise in making the diagnosis.

To make the diagnosis of psoriatic arthritis, your doctor may:

• Examine you for swollen and painful joints and for skin and nail changes.
• Take X-rays to look for damage to your joints.
• Do scans such as an MRI or ultrasound to get a more detailed look at your joints.
• Do blood tests to make sure you don’t have other types of arthritis.

How is PsA treated?

Treatment for PsA depends on the amount of joint pain, stiffness, and swelling a person has. If symptoms are mild, treatment may consist of over-the-counter or prescription oral medicines when pain and/or stiffness are present. The medicines can be stopped when the symptoms are under control.

Depending on the severity of symptoms, doctors may prescribe medicines that are taken orally, injected, or given through an IV (through the vein) for skin and joint symptoms and to help slow further joint damage. Sometimes they prescribe combinations of medicines as they deem appropriate for the patient.

In addition to taking their medicines as directed, it’s important that people with the condition live a healthy lifestyle. This includes not smoking, maintaining a healthy weight, protecting their joints from injury, being physically active, and reducing stress. Speak with your healthcare provider for more healthy living tips.

If you think you have signs or symptoms of PsA, talk with your doctor right away. This tool provided by the American College of Rheumatology can help you find a rheumatologist in your area.

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