Most people think psoriasis is an autoimmune disease that only affects the skin, but did you know that about 26% of people also have psoriatic arthritis? Did you know that psoriatic arthritis is more common than rheumatoid arthritis?[1] What are the signs of psoriatic arthritis?
8 Warning signs of psoriatic arthritis
1. Having nail psoriasis
A recent Japanese study tried to find risk factors that predispose people with psoriasis to develop psoriatic arthritis. First, they found that about 17% of people with psoriasis also had psoriatic arthritis. Furthermore, they found that people who had psoriasis involving their nails had a higher chance of having psoriatic arthritis: 29% (PsO) versus 62% (PsA). In conclusion, they found that people who had high uric acid levels also had a higher risk of having psoriatic arthritis 9% (PsO) versus 22% (PsA).[2]
How does nail psoriasis look like?
Nail psoriasis can sometimes mimic nail fungus. It can also make pits in the nail and can cause nails to break very easily.
Follow the link for examples.
2. Having autoimmune joint pain
Autoimmune joint pain typically causes swelling and warmth of the joints. People often describe stiffness that lasts more than one hour. Symptoms are worse in the morning. Furthermore, psoriatic arthritis can affect almost any joint: knuckles, toes, wrists, ankles, knees, etc.
3. Inflammation involving the tips of your fingers
I’m referring to the tips of the fingers, also called the distal interphalangeal joints. Osteoarthritis (i.e., wear and tear arthritis) in the hands can sometimes cause similar symptoms. Typically, the symptoms in psoriatic arthritis happen more quickly and typically there is more swelling and redness.
4. “Sausage fingers”
This happens when the tendons and ligaments that supply fingers get inflamed. This can happen in a variety of different diseases such as ankylosing spondylitis, reactive arthritis, inflammatory bowel disease, infection, sickle cell anemia, sarcoidosis, and gout to name a few. Follow the link to look at some examples.
5. Having inflammation of tendons and ligaments
Enthesitis means inflammation of connective tissue that attaches to bones. These include tendons, ligaments, and bursae. Most cases of enthesitis are due to injury or overuse. Think of a marathon runner with Achilles tendinitis or a tennis player with tennis elbow. In psoriatic arthritis, the immune system attacks these connection points. So you can have someone who leads a fairly sedentary life who suddenly develops Achilles tendinitis on both feet, runner’s knee, and plantar fasciitis happening all at once, for no good reason.
6. Autoimmune back pain
Inflammation involving the back causes symptoms that are very different from your usual mechanical back pain. Here are some key features:
- Back pain present for more than three months.
- Pain improves with exercise.
- Pain improves with anti-inflammatory medications like naproxen or ibuprofen.
- Rest usually worsens the pain.
- Back pain that wakes you up during the second half of the night.
- Pain and prolonged stiffness in the morning, typically lasting more than an hour.
- Alternating deep buttock pain.
7. History of uveitis
Uveitis is a general term used to describe a group of diseases that cause inflammation in the eye: uvea, lens, retina, optic nerve, and the vitreous. Depending on where the inflammation is happening, your ophthalmologist may describe it as anterior uveitis, intermediate uveitis, posterior uveitis, or panuveitis. As a result, people can experience blurry vision, eye pain, redness, sensitivity to light, and sometimes headaches.
Uveitis is associated with many diseases including psoriasis and psoriatic arthritis. Sometimes uveitis is the first manifestation of psoriatic arthritis. This is why I’ve included this topic here, even though technically it isn’t arthritis. It’s important to keep this in the back of your mind.[3] While uveitis is one of the signs of psoriatic arthritis, psoriatic arthritis is not the most common cause of uveitis.
8. Having a first degree family member with psoriasis or psoriatic arthritis
This means mom, dad, siblings, and children. Furthermore, other diseases also increase risk. These include Crohn’s disease, ulcerative colitis, ankylosing spondylitis, reactive arthritis, and uveitis.
Call to action
In conclusion, if you think you may have psoriatic arthritis, I encourage you to contact a rheumatologist to get tested. Time is of the essence. Click on “FIND A RHEUMATOLOGIST” above to search the American College of Rheumatology database to find a rheumatologist near you.
Want to learn more? The Arthritis Foundation and the Arthritis Society are also great starting points.
Medical Disclaimer
This information is offered to educate the general public. The information posted on this website does not replace professional medical advice, but for general information purposes only. There is no Doctor – Patient relationship established. We strongly advised you to speak with your medical professional if you have questions concerning your symptoms, diagnosis and treatment.
References
[1] Rheumatology Secrets, 3rd edition
[2] Tsuruta N, Imaguku S, Narisawa Y. Hyperuricemia is an independent risk factor for psoriatic arthritis in psoriatic patients. J Dermatol. 2017 Jul 10. doi: 10.1111/1346-8138.13968. [Epub ahead of print]
[3] https://nei.nih.gov/health/uveitis/uveitis