Psoriatic arthritis is a form of arthritis connected to the skin condition psoriasis. If the body produces too many skin cells, as in the case of psoriasis, red patches with silvery scales appear on joints like the elbows and knees. Some people develop psoriatic arthritis after receiving a psoriasis diagnosis, but joint problems can emerge before any skin patches are evident. Symptoms of psoriatic arthritis overlap with those of many other conditions, which makes diagnosis difficult. There is no cure for psoriatic arthritis. Treatment focuses on managing symptoms and preventing further joint damage.
Psoriatic arthritis is a chronic disease that worsens over time, but the symptoms often fluctuate, and everyone experiences them differently. Some people have mild symptoms, while for others, it becomes debilitating. People with psoriatic arthritis experience periods of increased activity, "flares," that alternate with periods of remission.
One of the hallmark symptoms of psoriatic arthritis is joint pain. Typically, this pain affects the fingers, lower back, knees, ankles, and toes. Sometimes, pain in the lower back is a symptom of ankylosing spondylitis, a form of inflammatory arthritis that affects the vertebrae. Pain in the top joints of the fingers is also a sign of gout. For these reasons, it can be difficult to get an accurate diagnosis without further investigation.
Another sign of psoriatic arthritis is stiffness affecting one or multiple joints, the severity of which depends on depending on how much the tissues around the joint have swollen. It can be physically difficult for people with psoriatic arthritis to get out of bed in the morning or to get moving again after a long period of sitting still. Stiffness can also be a sign of osteoporosis which, again, makes it difficult to get a fast and accurate diagnosis.
Skin rashes are one of the symptoms that helps doctors confirm a diagnosis of psoriatic arthritis. If psoriasis presents before psoriatic arthritis, thick red skin rashes with flakey silver patches appear over the joints, particularly the knees and elbows. Nails can also lift off the nail bed and become thick and pitted.
A lot of people with psoriatic arthritis experience dactylitis or swelling of the fingers or toes. The symptom affects the length of the digit, from the very tip to the base, and can, at time, be so severe that the fingers and toes look like sausages. This uncomfortable or painful symptom is another telling one that can help confirm a diagnosis of psoriatic arthritis.
People with psoriatic arthritis can also experience eye changes, some of which can be quite severe. They may develop conjunctivitis, where the tissue around the eyes gets pink and itchy. Irritation and redness in and around the eyes is common. A more severe eye change is uveitis, swelling of the sclera and cornea that results in significant vision disturbances, including blindness.
Tendon and ligament pain can develop for myriad reasons, one of which is psoriatic arthritis. This pain usually occurs where these tissues attach to bones and most commonly affects the elbows, bottom of the foot, or the heel, which lead to diagnoses of tennis elbow, plantar fasciitis, or Achilles tendinitis, respectively. Any of these can also be caused by a sports injury.
Decreased range of motion is common in psoriatic arthritis, especially during a flare. Swelling, stiffness, and pain all contribute to the person being unable to move their extremities as much as is normal. This is a common symptom of most forms of arthritis, though, and is not indicative of this particular type.
People with psoriatic arthritis experience fatigue that can be debilitating at times. This is a common symptom of rheumatoid arthritis, too, which can again complicate diagnoses. There are a lot of reasons for this fatigue, but joint, tendon, and ligament pain are significant contributing factors.
Psoriatic arthritis is closely linked to several other diseases and complications. Not only is it connected to Crohn's disease, but the condition can also cause inflammation that leads to lung damage and increases the risk of heart attacks and stroke. Osteoporosis, gout, high blood pressure, depression, and metabolic syndromes can also co-occur with psoriatic arthritis.
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