Psoriatic Arthritis

Psoriasis is an autoimmune condition in which the body's immune system attacks healthy cells and tissues. A hallmark of psoriasis are red, itchy silvery scaly patches, commonly seen on the knees, elbows, trunk, and scalp. Psoriatic arthritis is a form of arthritis resulting from an autoimmune disease causing joint inflammation, mild to severe joint pain, joint stiffness, and joint swelling.

Psoriatic arthritis affects up to 30% of patients with psoriasis and causes joint bone destruction and articular disease. This condition affects men and women equally. Many people with psoriatic arthritis have a family history of the disease.
Most individuals develop psoriasis before symptoms of psoriatic arthritis. For some, joint pain and swelling manifest before the psoriasis diagnosis. Both psoriatic arthritis and psoriasis are chronic conditions that typically worsen over time with intermittent periods of symptom relief, improvement, and remission.
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Psoriatic Arthritis Symptoms

Psoriatic arthritis commonly results in nail psoriasis with pitting, ridging, or crumbling fingernails. This nail disease can also manifest in thickened, discolored, and deformed nails, which separate from the nail bed. Damage to joints results in the deformed end of finger bone, finger joint deformity (distal flexion deformity). Joints may feel painful, warm, red, swollen, and stiff. Frequently, fingers and toes resemble sausages. The psoriatic arthritis symptoms are similar to those of rheumatoid arthritis and inflammatory arthritis; however, with psoriatic arthritis, the swelling affects the whole finger rather than the middle joint. Also, you may not feel the symptoms in both hands. 

A small percentage of people with psoriasis and psoriatic arthritis develop psoriatic arthritis mutilans - a severe, painful, and disabling form of psoriatic arthritis. Over time, psoriatic arthritis mutilans destroys the small finger bones, leading to permanent deformity.
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Psoriatic Arthritis Diagnosis

The hand surgeon at MD West ONE will examine and feel your hand and order imaging tests. If you have psoriatic arthritis, the x-ray may show joint swelling, narrowing of joint spaces, or fused bones. 

Treatment Plan and Treatment Options

There is no cure for psoriatic arthritis. The goals of treatment are to control symptoms and prevent further joint damage. Without treatment, psoriatic arthritis becomes disabling.
Nonsteroidal anti-inflammatory drugs and anti-rheumatic drugs may help lessen the swelling, redness, and pain to keep the hands functioning. Steroid injections may provide temporary relief for joint symptoms in daily activities. Biologic agents may help manage chronic flare-ups and reduce joint destruction. A biologic injection is usually self-administered or administered by a rheumatologist.
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You may also work with a physical therapist or a hand therapist to help you develop an exercise program as part of physical therapy regimen to alleviate the joint symptoms. Physical activity is known to reduce joint pain in people with arthritis. Surgery is also an option, depending on your specific case.