PSORIATIC ARTHRITIS

Definition

Psoriatic arthritis is an arthritis that is often associated with psoriasis of the skin.

Alternative Names

Arthritis - psoriatic

Causes, incidence, and risk factors

Psoriasis is a common, chronic skin condition that causes red patches on the body. About 1 in 20 individuals with psoriasis will develop arthritis along with the skin condition. In the majority of cases, psoriasis comes before the arthritis.

The disorder can be exhibited in a variety of ways. The arthritis is generally mild and involves only a few joints. In a few people, the disease is severe and usually affects the fingers and the spine. When the spine is affected, the symptoms are very much like those of ankylosing spondylitis.

The cause of psoriatic arthritis is not known, but genetic factors may play a role. In general, people who have psoriasis have a higher prevalence of arthritis than the general population.

Symptoms

• Nail abnormalities , or skin lesions of psoriasis
• Joint swelling and joint pain (arthritis)
  • Usually of the fingers and toes, but other joints can be affected
  • Wrist pain , knee pain , hip pain , elbow pain , ankle pain
• Pain and swelling at the site of attachment of tendons to bone
  • The Achilles tendon is often involved

Signs and tests

During a physical examination, the doctor will identify skin lesions, tenderness, and swelling of joints. Joint X-rays may be performed.

Treatment

Treatment of psoriatic arthritis involves medication, patient education, and physical and occupational therapy.

Nonsteroidal anti-inflammatory medications (NSAIDS) or salicylates are used to reduce pain and inflammation of the joints. More severe arthritis requires treatment with more powerful drugs called disease-modifying antirheumatic drugs (DMARDS). Occasionally, particularly painful joints may be injected with steroid medications.

Recently, new medications have been introduced. Inhibitors of the inflammatory protein called tumor necrosis factor (TNF) are fast becoming the treatment of choice. These include etanercept (Enbrel), infliximab (Remicade), and adalimumab (Humira).

Rarely, surgery to repair or replace damaged joints will be performed.

Get rest and exercise. To increase mobility, physical therapy provides exercise programs for specific joints. Heat and cold applications, or hydrotherapy may also be used.

Support Groups

Expectations (prognosis)

The course of the disease is often mild and affects only a few joints. In those with severe arthritis, treatment is usually very successful in alleviating the pain.

Complications

Repeated episodes may occur.

Calling your health care provider

Call for an appointment with your health care provider if arthritis symptoms develop along with psoriasis.

Prevention

There is no proven prevention of psoriatic arthritis.

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