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Psoriatic Arthritis

(Arthritis, Psoriatic; PsA)

Definition

Psoriatic arthritis is a disorder of the joints. It results in pain, stiffness, and swelling of the joints and the ligaments and tendons around them.

Psoriasis
Psoriasis

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Causes

Psoriatic arthritis is caused by a problem with the immune system. It beings to attack healthy tissue. It is not known why this happens. Genes and the environment may play a role.

Risk Factors

This problem is most common in people who are 30 to 50 years of age. It is also more common in people who have psoriasis. However, not everyone with psoriasis will get this problem.

Other things that may raise the risk are:

  • Having other family members with this problem
  • Certain genetic factors
  • Recent trauma, such as a joint injury

Symptoms

Problems may be:

  • Pain and swelling in one or more joints
  • Joint stiffness, especially in the morning
  • Red or warm joints
  • Pain and swelling over tendons
  • Swelling of the fingers or toes
  • Nail changes, such as pitting, crumbling, or separating from the nail bed
  • Back pain
  • Lack of energy
  • Redness and pain of the eye

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood tests will be done to rule out rheumatoid arthritis.

Images of the joints may be taken to confirm the diagnosis. This can be done with:

Treatment

There is no cure. The goal of treatment is to manage symptoms and slow joint damage. Options are:

  • Lifestyle changes, such as maintaining a healthy weight and exercising regularly
  • Medicines to ease pain and swelling, such as:
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Steroid medicine
    • Disease-modifying anti-rheumatic drugs (DMARDs)
    • Tumor necrosis factor (TNF) inhibitors

People who are not helped by these methods may need surgery. It may be done to repair or replace a damaged joint.

Prevention

There are no current guidelines to prevent this health problem.

RESOURCES:

Arthritis Foundation
http://www.arthritis.org

National Psoriasis Foundation
http://www.psoriasis.org

CANADIAN RESOURCES:

The Arthritis Society
http://arthritis.ca

Canadian Rheumatology Association
http://rheum.ca

REFERENCES:

About psoriatic arthritis. National Psoriasis Foundation website. Available at: https://www.psoriasis.org/psoriatic-arthritis. Accessed February 11, 2021.

Psoriatic arthritis. Arthritis Foundation website. Available at: http://www.arthritis.org/about-arthritis/types/psoriatic-arthritis. Accessed February 11, 2021.

Psoriatic arthritis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/psoriatic-arthritis. Accessed February 11, 2021.

Ritchlin CT, Colbert RA, et al. Psoriatic Arthritis. N Engl J Med. 2017 Mar 9;376(10):957-970.

Last reviewed December 2020 by EBSCO Medical Review Board James P. Cornell, MD  Last Updated: 2/11/2021