Psoriatic arthritis (PsA) is a long-term (chronic) form of arthritis which affects joints (such as the knees or those in the hands and feet), as well as areas where tendons join to bone (such as the heel and lower back). In some people, it is mild, with just occasional flare ups. In other people, it is continuous and can cause joint damage if it is not treated.1,2
Who is affected by psoriatic arthritis?
PsA usually appears in people between the ages of 30 to 50, but can begin as early as childhood. Men and women are equally at risk. PsA typically occurs in people with skin psoriasis, but it can occur in people without skin psoriasis, particularly in those who have relatives with psoriasis. It is estimated that PsA affects between 0.1-0.3 percent of the total UK population.2,3
What are the symptoms of psoriatic arthritis?1,4
Symptoms of PsA can include:
- Swollen, stiff and tender joints, especially first thing in the morning
- Swollen fingers or toes (dactylitis)
- Pain in areas where tendons attach to bone (enthesitis)
- Pitting, discolouration and thickening of nails
How is psoriatic arthritis diagnosed?
There is no conclusive test for psoriatic arthritis and it can therefore be a difficult condition to diagnose. Rheumatologists look for swollen and painful joints, certain patterns of arthritis, and skin and nail changes. X-rays are often taken to look for joint damage. MRI, ultrasound or CT scans can be used to look at the joints in more detail. Blood tests may be carried out to rule out other types of arthritis that have similar signs and symptoms, such as rheumatoid arthritis.2
How is psoriatic arthritis treated?4
There is no cure for PsA, as once joint damage has occurred it cannot be reversed. However, there are ways symptoms can be managed to slow progression, such as medical treatment and physical activity.
The main types of medicines used to treat PsA are as follows:
- Analgesic drugs (painkillers)
- Non-steroidal Anti-Inflammatory Drugs (NSAIDs)
- Ointments for the skin
- Disease Modifying Antirheumatic Drugs (DMARDs)
- Biological therapies
1. Psoriasis Association 2018. https://www.psoriasis-association.org.uk/psoriasis-and-treatments/psoriatic-arthritis (last accessed April 2018)
2. American College of Rheumatology 2018. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis (last accessed April 2018)
3. National Institute for Health and Care Excellence. Final scope: Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis (review of TA104 and TA125). May 2009. https://www.nice.org.uk/guidance/ta199/documents/psoriatic-arthritis-etanercept-infliximab-golimumab-and-adalimumab-review-final-scope2
4. What treatments are there for psoriatic arthritis? Arthritis Research UK. https://www.versusarthritis.org/about-arthritis/conditions/psoriatic-arthritis/