Symptoms of Psoriatic Arthritis

In This Article

Psoriatic arthritis is an inflammatory type of arthritis associated with the chronic skin condition psoriasis. It usually develops between 30 and 50 years old, but it can begin in childhood. Men and women seem to be equally affected by psoriatic arthritis.

It is an autoimmune disease that can run in families. There is an increased risk of developing the condition if someone has parents or siblings with the disease. It is important to recognize the signs and symptoms of psoriatic arthritis so a doctor can diagnose the condition and begin treatment.

According to the American College of Rheumatology, 85 percent of patients with psoriatic arthritis develop psoriasis first and roughly 15 percent of people with psoriasis develop psoriatic arthritis. However, some patients may develop arthritis first and later show signs of psoriasis.

Frequent Symptoms

Psoriatic arthritis symptoms vary from person to person and may even change in the same person over a period of time. Symptoms may occur at any time, flare up, and then disappear or persist over time.

Some people with psoriatic arthritis have persistent inflammation which requires proper treatment to prevent joint damage and disability. Common symptoms include:

  • Pain and swelling in one or more joints, often the wrists, knees, ankles, and joints at end of fingers and toes
  • Swelling of fingers and toes causing them to appear sausage-like
  • Low back pain or buttocks pain
  • Silvery or grayish scaly spots often on scalp, elbows, knees, lower end of the backbone
  • Pitting of fingernails or toenails
  • Fatigue
  • Morning joint stiffness
  • Tendinitis
  • Conjunctivitis

Sub-Types

There are five sub-types or patterns of psoriatic arthritis. Some people's symptoms may evolve from one form to another, or sub-types may overlap.

Asymmetric psoriatic arthritis

Most often psoriatic arthritis is first noticed in this stage. Asymmetric psoriatic arthritis involves a few joints randomly, such as the left elbow and right knee. This accounts for about 30 to 50 percent of psoriatic arthritis patients.

Symmetric psoriatic arthritis

Symmetric psoriatic arthritis is characterized by pain and swelling in the same joints on both sides of the body. Fingers and toes are often affected. This type is the most common form of psoriatic arthritis, affecting about 80 percent of people with psoriatic arthritis.

Distal interphalangeal predominant psoriatic arthritis

This form mostly involves joints closest to the nails of the fingers and toes, but other joints may also be affected. The distal interphalangeal predominant variety also causes changes to the fingernails and toenails, including pitting, splitting, degeneration, and other nail manifestations. This type of psoriatic arthritis accounts for 25 percent of cases.

Arthritis mutilans

Arthritis mutilans is a rare, painful, and destructive type of psoriatic arthritis. It is characterized by a condition called enthesitis, and inflammation where tendons and ligaments attach to bones. Resorption of phalangeal bones may also occur. This type of psoriatic arthritis accounts for 5 percent of all cases.

Psoriatic spondylitis or axial arthritis

This form is characterized by two distinct conditions that occur either together or separately, sacroiliitis and spondylitis. Sacroiliitis is an inflammation of the pelvic area where the sacrum joins the ilium bone. Spondylitis is an inflammation of one or more vertebrae, and about half of those with this condition are positive for the genetic marker HLA-B27. This form of psoriatic arthritis affects between 30 percent and 35 percent of patients.

When to See a Doctor

If you have symptoms of psoriatic arthritis, speak to your doctor. Psoriatic arthritis is typically diagnosed and treated by a rheumatologist, who will examine you, take images, and order bloodwork to rule out other conditions.

Early diagnosis and early treatment are important to bring the disease under control, providing the best chance to prevent disability, disease progression, and permanent joint damage.

Before your appointment, keep a diary or journal to document symptoms so you can accurately report it to your doctor.

Psoriatic Arthritis Doctor Discussion Guide

Print out this guide, fill it out and bring it to your doctor appointment to help guide your discussion and help you ask the right questions.

Doctor Discussion Guide Woman

A Word From Verywell

Without proper diagnosis and treatment, psoriatic arthritis can lead to a reduced quality of life and disability. If you think you may have psoriatic arthritis, speak to your doctor and start treatment as quickly as possible. Psoriatic arthritis can be managed successfully by following your doctor's treatment plan, managing stress, and practicing self-care.

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Article Sources
  • Johns Hopkins Arthritis Center. Psoriatic Arthritis. www.hopkinsarthritis.org/arthritis-info/psoriatic-arthritis/

  • Kelley's Textbook of Rheumatology. Elsevier. Ninth Edition. Chapter 77. Psoriatic Arthritis.

  • Arthritis Foundation. Psoriatic Arthritis. https://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/

  • American College of Rheumatology. Psoriatic Arthritis. www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis