Psoriatic Arthritis

             Psoriatic arthritis is a chronic arthritis that often occurs in people with psoriasis, a skin condition causing red patches of skin covered with silvery scales. Most of psoriatic arthritis is diagnosed after the appearance of psoriasis. Some cases may have joint problems before the appearance of skin patches.

            The main signs and symptoms of psoriatic arthritis are joint pain, stiffness and swelling. Any part of the body can be affected including fingertips and spine. The range of the disease may be mild to severe. Moreover, the spread of the disease may differ from the durations of the relief. In addition, there is no specific treatment for psoriatic arthritis. The aims of the treatment are to control the symptoms and to prevent the damage of the joints. Untreated psoriatic arthritis may lead to a disability in some cases.

Symptoms

             These chronic diseases may get worse as time goes by. The symptoms of both psoriatic arthritis and psoriasis may be improved and get worse chronically.

            Any part of the body can be affected either on one or both sides. The signs and symptoms of the disease could be similar with rheumatoid arthritis which cause joint pain, swollen and warm as touched. Psoriatic arthritis may also causes:

• Foot pain

People with psoriatic arthritis may experience foot pain especially at the back of the heel or the sole of the foot.

• Lower back pain

• Swollen fingers and toe

When to see the doctor

             There is a relationship between psoriatic arthritis and psoriasis, so inform the doctor if joint pain also occurs. Untreated psoriatic arthritis could cause severe damage which may lead to disability.

Cause

             Psoriatic arthritis is caused by an inflammation in the joint as the response of an abnormal immune system. The reason for this is still unclear but both genetic and environmental factors might be associated. It is also found that people whose family member has been involved with psoriatic arthritis has a tendency to have the disease. Moreover, viral or bacterial infections may be the triggers of the disease.

Risk factors

            There are risk factors that increase the risk of the disease including:

• • Psoriasis
  • Family history of psoriatic arthritis
  • Age

Adults between the age of 30-50 tend to have psoriatic arthritis more than other ranges of age.

Complications

             A severe condition of the disease called arthritis mutilans may occur in a small percentage of people with psoriatic arthritis. Arthritis mutilans causes a painful and disabling form of the disease. The small bones in hands, especially fingers may be destroyed which lead to permanent deformity and disability.

            Some eye problems such as conjunctivitis or uveitis may occur in some people with psoriatic arthritis. These eye problems may cause painful, reddened eyes and blurred vision.

Diagnosis

             The doctor may conduct some exams to:

• • examine the signs of swelling or tender joints.
  • check for pitting, flaking and other abnormal fingernails.
  • find the tender areas of the heel by pressing on the soles of the feet.

The doctor may investigate the cause of the symptoms and differentiate between the psoriatic arthritis and other arthritis such as rheumatoid arthritis or gout by conducting some tests including:

• Image tests

• • X-rays

To locate changes in the joints occuring in psoriatic arthritis

• • MRI

To check for problems with ligaments and tendons in the feet and lower back

• Laboratory tests

Treatment

             There is no specific treatment for psoriatic arthritis. The purposes of the treatment are to control the inflammation and to prevent joint pain and disability. The treatment for psoriatic arthritis may include:

• Medications    

• • NSAIDs
  • Disease-modifying antirheumatic drugs (DMARDs)
  • Immunosuppressants
  • Biologic agents
  • Newer oral medication

• Surgical and other procedures

• Steroid injection

To faster reduce the inflammation, the doctor may inject this type of medication into an affected joint.

• Joint replacement surgery

The doctor may recommend joint replacement surgery to patients with severe psoriatic arthritis whose joints are severely damaged.

Change of lifestyle and home treatment

• Joints protection

Raise your awareness of any activity that may affect the joints. You may protect the joints by changing or adapting some of the habits, such as avoiding straining the finger joints by pushing doors with your whole body instead of a finger.

• Regularly Exercise

Some exercises, such as swimming, walking and biking might help promote flexible joints and strong muscles.

• Weight control

• Quit smoking

• Limit alcohol use

• Activate yourself

Preparing for the appointment

Before your appointment, you may prepare a list that include:

• symptoms that you are having
• the beginning of the symptoms
• the family history of arthritis or psoriasis
• recently consumed medications and supplements

 During the consulting, the doctor may ask some questions including the information such as:

• the affected joints
• activities or positions that either relieve or worsen the symptoms
• treatment that you have tried and its effectiveness