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PSORIATIC ARTHRITISPSORIATIC ARTHRITISPsoriatic arthritis is a specific type of arthritis that has been diagnosed in approximately 23 percent of people who have psoriasis. It commonly affects the ends of the fingers and toes. It can also affect the spine. Psoriatic arthritis is a long-lasting condition that causes skin rashes and produces joint inflammation. Over 80% of people with psoriatic arthritis also have involvement of the finger and toenails. The pattern of joint involvement varies widely in people with psoriatic arthritis, though it can affect the wrists, knees, ankles, finger and toe joints, the spine, and the sacroiliac joints (joints in the lower back where the spine connects with the hips). Psoriatic arthritis is linked to psoriasis, a disorder causing areas of the skin to become inflamed and be covered with silvery or grey scales. Psoriasis can also cause the nails on the hands and feet to develop small holes and to lift. Psoriatic arthritis can develop at any time. On average, it appears about 10 years after the first signs of psoriasis. For most people it appears between the ages of 30 and 50. It affects men and women equally. In about one of seven people with psoriatic arthritis, arthritis symptoms occur before any skin lesions. Like rheumatoid arthritis, psoriatic arthritis is thought to be caused by a malfunctioning immune system. Psoriatic arthritis is usually milder than rheumatoid arthritis, but some patients with psoriatic arthritis have as severe a disease as patients with rheumatoid arthritis. Psoriatic arthritis can start slowly with mild symptoms, or it can develop quickly. It is very important to have as early and accurate a diagnosis as possible. Left untreated, psoriatic arthritis can be a progressively disabling disease. In fact, half of those with psoriatic arthritis already have bone loss by the time the disease is diagnosed. Since this form of arthritis is similar to other forms such as gout, Reiter's syndrome and rheumatoid arthritis, your doctor may perform a physical examination and order various tests to assist in diagnosis. X-rays are often ordered to look for changes to the bone. Blood and joint fluid tests may be done to rule out other conditions such as rheumatoid arthritis, reactive arthritis or gout. Once the diagnosis is confirmed various treatments can help decrease your pain and stiffness and increase your movement. About 95% of those with psoriatic arthritis have swelling in joints outside the spine, and more than 80% of people with psoriatic arthritis have nail lesions. The course of psoriatic arthritis varies, with most doing reasonably well. Symptoms include: • Silver or grey scaly spots on the scalp, elbows, knees and/or lower end of the spine. • Pitting of fingernails/toenails • Pain and swelling in one or more joints • Swelling of fingers/toes that give them a "sausage" appearance. • Stiffness, pain, swelling and tenderness of the joints and surrounding soft tissue • Reduced range of motion • Morning stiffness and tiredness • Nail changes, including pitting (small indentations in the nail) or lifting of the nail—found in 80 percent of people with psoriatic arthritis • Redness and pain of the eye, similar to conjunctivitis |
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