What is psoriatic arthritis?
Psoriatic arthritis is an autoimmune condition that causes inflammation in the joints and the areas where tendons and ligaments attach to bone, known as entheses. It belongs to a group of inflammatory conditions called spondyloarthropathies and can affect people differently, ranging from mild symptoms to more widespread joint involvement.
The condition is closely associated with psoriasis, a chronic skin condition characterised by red, scaly patches of skin. However, not everyone with psoriatic arthritis will have visible psoriasis at the time of diagnosis.
Without appropriate treatment, ongoing inflammation may lead to joint damage, reduced mobility and a significant impact on quality of life.
What are the symptoms of psoriatic arthritis?
The symptoms of psoriatic arthritis can vary considerably between individuals and may develop gradually or appear suddenly.
Common symptoms of psoriatic arthritis include:
- Joint pain, swelling and tenderness
- Morning stiffness lasting more than 30 minutes
- Swelling of an entire finger or toe (dactylitis)
- Pain where tendons or ligaments attach to bone, particularly around the heels and feet
- Lower back or neck pain
- Fatigue and reduced energy levels
- Nail changes, including pitting, thickening or separation from the nail bed
- Psoriasis skin plaques
- Eye inflammation (uveitis)
Because many symptoms overlap with other forms of arthritis, obtaining an accurate psoriatic arthritis diagnosis is essential to exclude other conditions.
Psoriatic arthritis diagnosis tests include:
- X-rays: To show changes in the joints that are not seen in other types of arthritis.
- MRI scans: To evaluate the tendons and ligaments in the feet and lower back.
- Rheumatoid factor test (RF test) and CCP antibody: To look for the antibody possessed in those with Rheumatoid arthritis.
- HLA B27 genetic marker blood test: Assessment for specific genetic markers related to spondyloarthropathies.
- Joint fluid test: Where a small sample of fluid from the swollen joint is taken and tested for uric acid crystals.
How to treat psoriatic arthritis?
Understanding how to treat psoriatic arthritis begins with tailoring treatment to the severity of symptoms, the joints involved and the impact on your daily life.
Treatment plans are personalised and designed to control inflammation, relieve symptoms, preserve joint function and support long-term wellbeing.
Treatment options may include:
- Medications
- Targeted steroid injections (soft tissue or joint)
- Conventional DMARDs, which slow down the disease and prevent lasting joint damage (eg. Methotrexate, Leflonumide)
- Biologic DMARDs, which target specific parts of the immune system causing joint inflammation (Adalimumab, Secukinumab, Bimekizumab)
- Targeted synthetic DMARDs, used to lessen inflammation if conventional DMARDs and biologic agents haven’t helped (eg. Upadacitinib)
- Physical and occupational therapy can help lessen pain and improve movement
Dr Nuttall will tailor treatment to reduce inflammation, improve mobility, and support long-term joint health.
