Psoriatic Arthritis Signs And Symptoms

Psoriatic arthritis signs and symptoms can be varied somewhat from person to person. Arthritis is certainly not a condition which only affects those with psoriasis, because many people suffer with rheumatoid or osteoarthritis. With psoriatic arthritis however, only a small percentage of psoriasis sufferers with this form of arthritis and the two conditions are linked. In most cases, the psoriasis will almost always precede the arthritis anything from a few months to several years. Psoriatic arthritis is a very of painful arthritis which frequently involves the knees, ankles, and joints of the feet, but I’ve seen patients who had very painful fingers and wrists as well. In most cases, only a few joints are inflamed at any one time. The inflamed joints can become very painful, swollen, hot, and red – just like in rheumatoid arthritis, also an auto-immune condition.

Sometimes, joint inflammation in the fingers or toes can cause swelling of the entire digit, giving them the appearance of a “sausage.” Joint stiffness is common and is typically worse early in the morning. Less commonly, psoriatic arthritis may involve many joints of the body in a symmetrical fashion, mimicking the pattern seen in rheumatoid arthritis. Any joint can be affected in psoriatic arthritis, and this condition can also cause inflammation of the larger joints, such as the spine (spondylitis) and the sacrum, causing pain and stiffness in the low back, buttocks, neck, and upper back.

Patients with psoriatic arthritis can also develop inflammation of the tendons (tendinitis) and around the cartilage. Inflammation of the tendon behind the heel causes Achilles tendinitis, leading to pain with walking and climbing stairs. Inflammation of the chest wall and of the cartilage that links the ribs to the breastbone (sternum) can cause chest pain, as seen in costochondritis.

Aside from arthritis and spondylitis (the spine), psoriatic arthritis can cause inflammation in other organs, such as the eyes, lungs, and even the big blood vessel called the aorta. Inflammation in the iris of the eye causes iritis, a painful condition that can be aggravated by bright light (photophobia) as the iris opens and closes the opening of the pupil. Treatment may include a corticosteroid injection directly into the eye to decrease severe inflammation and prevent blindness. Inflammation in and around the lungs (pleuritis) causes shortness of breath and severe chest pain, especially with deep breathing. Shrotness of breath and even heart failure may occur due to inflammation of the aorta (aortitis) caused by a leakage of the aortic valve valves.

Many psoriatic patients I have seen over the years have different forms of acne and nail changes. Pitting and ridges are seen in fingernails and toenails of 80% of patients with psoriatic arthritis. Interestingly, only a minority of psoriasis patients who do not have arthritis have nail changes. Acne has been noted to occur in higher frequency in patients with psoriatic arthritis.

A new syndrome (SAPHO syndrome) as been described, characterised by inflammation of the joint lining (synovitis), acne and pustules on the feet or palms, thickened and inflamed bone (hyperostosis), and bone inflammation (osteitis).