Psoriatic Arthritis: Overview

Psoriatic arthritis causes inflammation in your joints. It happens because your immune system is overactive. It affects mostly people who have psoriasis, a skin disease that's also related to the immune system. Sometimes doctors misdiagnose it as gout, rheumatoid arthritis, or osteoarthritis.

Medication can control the inflammation, ease your symptoms, and prevent long-term joint damage. Exercise is another important way to take charge of the symptoms, including joint problems and fatigue.

Types of Psoriatic Arthritis

Symmetric psoriatic arthritis affects several joints in pairs on both sides of your body, like both elbows or both knees. It can be mild to severe. It destroys your joints over time, and they may stop working. That's why you need treatment. For about half of people with this type, it can be disabling. The symptoms of symmetric psoriatic arthritis looks like rheumatoid arthritis.

Asymmetric psoriatic arthritis typically affects only a few joints. They can be large or small and anywhere in your body. Fingers and toes may swell like sausages.

swollen finger joints

Distal interphalangeal predominant (DIP) psoriatic arthritis mainly affects small joints at the ends of the fingers and toes, as well as the nails. Sometimes it's confused with osteoarthritis, what most people think of when they hear "arthritis," when the cartilage and bone in the joints wears away.

Spondylitis affects the backbone. It can cause inflammation and stiffness between your vertebrae -- the bones of your neck, spine, and lower back -- and pelvis. Spondylitis can also attack ligaments that connect muscles to bones and other connective tissue.

Arthritis mutilans is the most severe and destructive form of psoriatic arthritis. Fortunately, it's rare. It damages the small joints in your fingers and toes so badly that they become deformed.

Causes

We don't know exactly why some people get the condition and others don't, but it seems to run in families. As many as 40% of people with psoriatic arthritis have a family member with skin or joint problems.

Up to a third of people who have psoriasis will get psoriatic arthritis. Psoriasis is a skin disease that causes a red, scaly rash, often over the elbows, knees, ankles, feet, and hands. It can also affect your nails. Both of these diseases happen because your immune system attacks your body instead of something from outside.

Psoriatic arthritis usually shows up between ages 30 and 50, but it may start in childhood. Both men and women get it. Many people have the skin disease first, but not everyone will.

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Symptoms

For some people, symptoms may be subtle and show up gradually. For others, they're sudden and dramatic.

No matter what type of psoriatic arthritis you have, you may notice:

It can also cause inflammation in other areas, including your eyes.

If your arthritis is mild, you may only have occasional flare-ups. But some people always have symptoms. The disease can cause permanent joint damage if it's not treated.

To diagnose psoriatic arthritis, your doctor will ask about your symptoms. She’ll also have you tell her about your medical history and your family’s. Blood tests, imaging, and other tests can help your doctor rule out other forms of arthritis that look similar.

People with psoriatic arthritis are more likely to be or become obese and have high blood pressure, high cholesterol, heart disease, and diabetes, too.

Treatment

You treat psoriatic arthritis by controlling the inflammation. The way you do that depends on how severe it is and what works for you. You'll probably need to take a medication, which could include a:

  • Nonsteroidal anti-inflammatory drug (NSAID)
  • Disease-modifying antirheumatic drug (DMARD)
  • Biologic drug
  • Enzyme inhibitor

Exercise is also important for you. It helps protect your joints by making the muscles around them stronger. Gentle, low-impact movement can lessen pain and expand your range of motion. Physical activity may help you relax, ease your stress, and sleep better, too.

Other ways to help manage psoriatic arthritis and protect your joints are:

There’s no cure for the condition, but newer medications can control it so well that it goes into remission, which means you have no symptoms.

WebMD Medical Reference Reviewed by David Zelman, MD on May 31, 2015

Sources

SOURCES:

National Psoriasis Foundation.

Arthritis Foundation.

American College of Rheumatology.

WebMD Medical Reference "Psoriasis."

News release, FDA.

American College of Rheumatology: "Psoriatic Arthritis."

Arthritis Foundation: "Psoriatic Arthritis."

MedlinePlus Medical Encyclopedia: "Psoriatic Arthritis."

National Institute of Arthritis and Musculoskeletal and Skin Disorders: "Roundtable Discussion on Psoriasis, Psoriatic Arthritis, and Rheumatoid Arthritis."

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