Patient Education

PSORIATIC ARTHRITIS

Psoriatic Arthritis

  • Psoriatic arthritis is not infectious or transmitted from one person to another
  • Psoriatic arthritis is different from rheumatoid arthritis so treatment is different
  • In psoriatic arthritis along with joint pain and swelling there is inflammation in the skin which is known as psoriasis
  • Some times skin disease occur after the arthritis so it is difficult in diagnosis during this period
  • Inform your rheumatologist if any of your family member is having psoriasis and you are having joint pain and swelling
  • Psoriatic arthritis oral steroid should be avoided

  • Psoriatic arthritis (PsA) is a type of unique inflammatory arthritis in which inflammation can affect both the joints and the skin.
  • In this disease along with joint pain and swelling there is white patches with silver scales over the skin.
  • PsA belongs seronegative spondyloarthropathies family which includes Ankylosing Spondylitis,Reactive Arthritis and IBD associated arthritis.
  • Psoriatic arthritis often has strong family history with psoriasis.
  • Any joints from the body that is starting from shoulder, wrist, small joints of hand, hip, knee, ankle and foot joints can be affected.
  • Psoriatic arthritis can also affect spine of neck and lumbar spine because of which patient will have difficulty in getting up from the bed.

  • Psoriatic arthritis is an autoimmune disease where the body’s immune system attacks its own joints as well as the skin.
  • The exact reason for onset this disease is not completely known
  • In comparison to other arthritis it has strong family history so genetics play a role
  • People with positive family history of psoriasis or psoriatic arthritis have a higher chance of developing psoriatic arthritis

 

  • So family history should be informed to your rheumatologist
  • Another thing psoriasis increased during any stress period, infection and also associated with smoking
  • So advised to stop smoking as early as possible to decrease the symptoms and improve the efficacy of the medicines.

  • Here in this disease both skin and joint gets affected.
  • Usually skin disease occur earlier then arthritis
  • Skin lesion are whitish patch with silver scales over it normally increased during any stress period and smoking. Upon removing the scales there is evidence of oozing of blood.
  • Sometime joint disease occurs earlier then skin disease where diagnosis becomes difficult in the absence of skin symptoms.
  • The affected joint becomes painful during movement and swelling. Pain and stiffness more in the early morning
  • Psoriatic arthritis can affect axial spine that is neck spine and also lumbar spine because of which there is early morning stiffness in the spine and difficulty in getting up from the bed.
  • Along with joint and spine PsA can cause pain the attachment of the muscle to the bone
     Ribs and sternum-Costochondritis
     Around the knee joint
     Outer aspect of pelvic bone
     Back of the heels-Achilis tendonitis
     Bottom of the heel-plantar fasciitis
  • PsA can cause swelling of whole fingers or toes sometime appear as “Sausage” shape known as ‘Dactylitis’.
  • It can affect the nails of finger and toes so it leads to nail pitting, lifting of nail from the nail bed.
  • Psoraisis skin lesions sometime occur at hidden areas such as scalp, behind the ear, axilla, around the umbelicus
  • About 1/3rd people with psoriasis develop arthritis in later period of life
  • If a person has family members who have psoriasis or psoriatic arthritis they have a higher chance of developing psoriatic arthritis
  • Can occur at any age starting from 30-50 yrs. of age

  • Complete history and performing thorough physical examination PsA can be diagnosed clinically
  • Detail family history of anyone having psoriasis

  • Always look at the hidden areas such as scalp, behind the ear, axilla, back area for Psoriasis

  • And examination nail of finger and toes for nail pitting or separation of nail from it’s bed
  • Some time blood tests are needed for the treatment and follow up period

  • Blood Tests
    o CBC
    o ESR
    o CRP quantitative
    o Liver Function Test
    o Kidney function test

  • Scans
    o Xray of the concerned area to look for the bony changes often needed
  • The chances of getting pregnant for people with PsA are the same as with people that don’t have it.
  • PsA as such also has no known effects on the developing fetus
  • Always inform your treating doctor before planning the pregnancy as sometime some drugs shouldn’t be continued during pregnancy and should be stopped 3-4 months prior to conception