What are the Symptoms and Signs of Psoriatic Arthritis?

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Most patients will have skin psoriasis, however some patients can develop arthritis prior to skin disease.  Sometimes the skin disease can be very mild and just include heavy dandruff from scalp involvement.  The presence of nail changes of psoriasis (pits, ridges, lifting of the nail) is more common in patients with associated arthritis

There is a wide variety of problems:

  • Swollen and painful joints (small or large joints)
  • Inflammatory back and buttock pain (pain worse in the morning and improving with activity)
  • Enthesitis (inflammation where tendons, ligaments and capsules attach to bone) – this can include a number of conditions – tennis elbow, Achilles tendinitis, plantar fasciitis, trochanteric bursitis.  If someone has a number of these conditions then psoriatic arthritis should be considered as a possible cause.
  • “Sausage digits” where an entire finger or toe is swollen.  There are few conditions other than psoriatic arthritis that can cause this.

Some patients have mild disease with very few clinical signs of inflammation but rather have grumbling chronic pain.