What is Psoriatic Arthritis?
Psoriatic Arthritis is a chronic disease characterized by inflammation of the skin (psoriasis) and joints (arthritis). Psoriasis is a common skin condition affecting 2% of the Caucasian population within the United States. It usually presents as patchy, raised, scaling, red areas of skin inflammation that are most commonly affecting the tips of the elbows, knees, and scalp. Psoriasis can often cause changes in your fingernails and toenails. Pitting and ridge formation in the nails is seen in correlation with psoriasis in 80% of the cases. 10% of patients that are affected by psoriasis will also develop an associated inflammation of their joints, hence psoriatic arthritis. Only patients with psoriasis are capable of having psoriatic arthritis.
The onset of Psoriatic Arthritis generally occurs in the 4th and 5th decades of life affecting both males and females equally. Although more commonly in our 30-50 year olds, children can be effected as well. The skin disease and the joint disease often appear at separate times; in fact the skin disease precedes the arthritic disease 80% of the time.
What causes Psoriatic Arthritis?
The cause of Psoriatic Arthritis is currently unknown. Most likely a combination of genetic and immune as well as environmental factors is involved.
Symptoms of Psoriatic Arthritis:
Like we have stated above the skin disease (psoriasis) will often precede the joint disease (arthritis) by months to years. The arthritis frequently involves the knees, ankles and joints in the feet, usually only a few joints are inflamed at one time. The inflamed joints become painful, swollen, warm to the touch, and red in color. Sometimes the joint inflammation can cause an entire toe to swell giving the appearance of a "sausage digit". Joint stiffness is a common side effect, with more stiffness in the morning hours.
Patients with psoriatic arthritis can also develop inflammation with the tendons (tendinitis) and around cartilage. Commonly the Achilles tendon is affected making it hard to walk and perform daily activities. Aside from arthritis, psoriatic arthritis can cause inflammation in other organs such as the eyes, lungs, and aorta.
Diagnosis of Psoriatic Arthritis:
Diagnosis is most often made on clinical grounds and the presentation of your symptoms. There is no laboratory test that is specific for psoriatic arthritis. There are certain blood tests that may be elevated and correlated to psoriatic arthritis. Commonly your doctor will have your blood tested for the rheumatoid factor, that will help exclude rheumatoid arthritis.
Treatment of Psoriatic Arthritis:
Generally the best treatment for psoriatic arthritis is a combination of anti-inflammatory medication (NSAIDS) and exercise. If progressive joint inflammation and destruction occur more potent medications may be necessary. The NSAIDS will work to reduce joint inflammation, pain and stiffness. Exercise programs can be done at home but will often be more effective when done with a physical therapist, which can be customized according to the disease and physical capabilities of each patient.