Skin & Bones

What to watch for

KNOW THE SIGNS, AND KNOW YOUR RISK

If you have psoriasis, there’s an almost 1 in 3 chance your joints may be affected at some point. Understanding your risk and regularly watching for the signs and symptoms can help you make the connection sooner.

Psoriatic arthritis can start at any age, but it often appears between ages 30 and 50. Keeping an eye out for swollen, tender and painful joints or tendons that might come on suddenly or grow over time—particularly in more than one place on your body—could help you spot the early signs. Similarly, watch for symptoms like fatigue, reduced range of motion, and morning stiffness or tiredness.

If you have psoriasis, there’s an almost 1 in 3 chance your joints may be affected at some point. Understanding your risk and regularly watching for the signs and symptoms can help you make the connection sooner.

Psoriatic arthritis can start at any age, but it often appears between ages 30 and 50. Keeping an eye out for swollen, tender and painful joints or tendons that might come on suddenly or grow over time—particularly in more than one place on your body—could help you spot the early signs. Similarly, watch for symptoms like fatigue, reduced range of motion, and morning stiffness or tiredness.


Even if you’ve had psoriasis for a while without joint problems, don’t forget about your joints. It can take a long time for psoriatic arthritis to appear after the first signs of psoriasis—sometimes about ten years. That said, in some cases the two diseases can appear at the same time, and in about 15% of cases, symptoms of arthritis are noticed before psoriasis appears.

ALMOST HALF

OF PEOPLE WITH PSORIATIC ARTHRITIS ALSO EXPERIENCE DACTYLITIS, WHICH CAUSES AN ENTIRE FINGER OR TOE TO SWELL; THIS IS SOMETIMES CALLED “SAUSAGE FINGER” OR “SAUSAGE TOE.”

~90%

OF PEOPLE WITH PSORIATIC ARTHRITIS SEE CHANGES IN THEIR NAILS.

Tough to nail down

Other things to watch for might not be as obvious, like your fingernails and toenails. Changes to your nails—like lesions or crumbling—could be early warning signs of psoriatic arthritis. It’s not uncommon to even see nails separating from the nail bed, or becoming pitted similar to a fungal infection.

 

In fact, while nail lesions are common in 40–45% of people who live with psoriasis (but who do not have psoriatic arthritis), up to 90% of people who do have psoriatic arthritis will have evidence in their nails.

Symptoms in disguise

The symptoms of psoriatic arthritis are easy to mistake for aches and pains due to injury or aging. In this video, Dr. Jodie Reis explains why it’s important to take notice if pain or swelling persist or get worse.

SYMPTOMS OF PSORIATIC ARTHRITIS (PsA) IN DETAIL

Psoriatic arthritis affects every person differently, but there are common signs and symptoms. Ask yourself if you experience symptoms in any of the following areas of your body:

  • The main symptoms among people with psoriatic arthritis are swelling, stiffness or pain in joints. These can range in severity.

     

    In some cases, disease flares may alternate with periods of remission.

     

    Interestingly, pain or stiffness in the joints that lasts 30 minutes or more just after waking up in the morning could also be a symptom of psoriatic arthritis.

  • A person’s fingernails or toenails can hold important clues to diagnosing psoriatic arthritis. The results of a Canadian study of people living with PsA found that more than 90% of them had some kind of psoriasis on at least one nail. The study also found that patients with a crumbling nail or separation of the nail from the skin underneath it were more likely to have swelling or tenderness in the finger joint closest to that nail, and those who had blood spots under their nails tended to have higher numbers of swollen joints.

    Changes to the nails might include:

    • crumbling
    • separation from the nail bed
    • ridges and splitting
    • spots of blood under the nail
    • buildup of keratin between the nail and nail bed
  • Occasionally, a person with psoriatic arthritis can see their entire fingers or toes become swollen and sausage-like (referred to as dactylitis).

  • Enthesitis is the inflammation of the entheses, the ropey or solid tissue around the tendons (which attach muscles to bones) or ligaments (which attach bones to one another). In the first study of its kind among patients with psoriatic arthritis, about 35% were found to have enthesitis.

     

    Enthesitis is a distinctive feature of psoriatic arthritis. Common locations for enthesitis include the bottoms of the feet, the Achilles tendons, and the places where ligaments attach to the ribs, spine and pelvis.

    Studies have found three risk factors for people with psoriatic arthritis to develop enthesitis:

    • a higher body mass index
    • a higher number of actively inflamed joints
    • being at a younger age
  • Sometimes, people with psoriatic arthritis experience redness and pain of the eye (called uveitis).

  • Fatigue or a reduced range of motion could also be potential signs of psoriatic arthritis.

    Similarly, some people develop a condition called spondylitis as a result of psoriatic arthritis. Spondylitis mainly causes inflammation of the joints between the vertebrae of the spine and in the joints between the spine and pelvis (also called sacroiliitis).

Remember to check in with my doctor if I'm experiencing any of the following: \n\n- Generalized fatigue\n- Tenderness, pain and swelling over tendons\n- Swollen fingers and toes\n- Stiffness, pain, throbbing, swelling or tenderness in one or more joints\n- Reduced range of motion\n- Morning stiffness and tiredness\n- Redness and pain in the eyes\n- Changes in the fingernails or toenails

Don’t forget your joints!

If you have psoriasis, it’s important to make the link between your skin and your bones. If you’re busy, you might need a reminder to check for symptoms like these.

add a reminder to your calendar