Adapted from the “Understanding Psoriatic Arthritis” DocTalk by Rheumatologist Daniel Moon, MD
0:14 | What is psoriatic arthritis?
Psoriatic arthritis is a type of inflammatory arthritis that takes place with skin psoriasis. While it was first thought to be a type of rheumatoid arthritis, it is seen as a unique clinical disease. It is important to know only up to 30% of people with psoriasis develop psoriatic arthritis. Those with higher risk of psoriatic arthritis may experience nail changes, as well as inverse psoriasis, which is skin psoriasis in the armpits, groin, and other body folds.
Most often, the skin rash seen with psoriasis comes before the signs or symptoms of arthritis. But for 10-15% of patients, arthritis will come before the skin psoriasis. Arthritis most often appears between the ages of 30 to 50. Symptoms can overlap with other medical conditions including ankylosing spondylitis or inflammatory bowel disease, which together create a family of diseases called spondyloarthritis.
1:34 | What causes psoriatic arthritis?
While the exact cause of psoriatic arthritis is not known, there are some genetic and environmental factors linked to it. For example, up to 40% of people with psoriatic arthritis have a family history of psoriasis or psoriatic arthritis.
Infections and gut microbe biome change have been proposed as environmental factors, but we don’t fully understand the exact causes of the disease yet.
2:09 | What are symptoms of psoriatic arthritis?
Psoriatic arthritis affects joints and the spine, as well as surrounding structures such as tendons. Symptoms include:
- painful swollen joints
- a sausage-like swollen finger or toe
- repeated inflammation at tendons and at the tendons’ insertion sites onto bones
- neck and back stiffness
- nail changes
2:36 | How is psoriatic arthritis diagnosed?
There is no one test to detect if a person has psoriatic arthritis. Your rheumatologist will look for painful swollen joints, certain patterns of arthritis, and the skin and nail changes of psoriasis. Blood work is usually done to rule out other types of arthritis. X-rays often are taken to look for joint damage. MRI and musculoskeletal ultrasound can also help diagnose the disease. Some rheumatologists, like me, go through more training to be certified in musculoskeletal ultrasound.
3:19 | How is psoriatic arthritis is treated?
People with mild arthritis may only need ibuprofen or naproxen, which are nonsteroidal anti-inflammatory drugs, also known as NSAIDs. If the arthritis does not respond, disease-modifying, anti-rheumatic drugs such as methotrexate, sulfasalazine or Otezla® may be used. There are many effective biologic-type medications now available for treating skin psoriasis and psoriatic arthritis. Rheumatologists work with their patients to decide the best course of treatment to meet each patient’s needs.
If you think you may need help for psoriatic arthritis, please call Valley Medical Center’s Rheumatology Clinic at 425.690.3495. Clinics are located in Covington and Renton. Learn more about rheumatologist Daniel Moon, MD.