In short
Psoriatic arthritis is inflammatory arthritis that affects some people with psoriasis, up to about 30% in some estimates. It can cause swollen joints, “sausage” fingers or toes, heel and tendon pain, back pain and nail changes. Early treatment can prevent joint damage.
On this page
What is psoriatic arthritis?
Psoriatic arthritis (PsA) is a type of inflammatory arthritis linked to psoriasis, a skin condition that causes red, scaly patches. Estimates suggest that up to about 30% of people with psoriasis develop PsA. In most people the skin condition comes first, but arthritis can start before the skin changes or at the same time.
Symptoms
- Painful, swollen joints, often in an uneven pattern
- Swelling of a whole finger or toe, so it looks like a sausage (dactylitis)
- Pain where tendons and ligaments attach to bone, such as the heel or sole of the foot (enthesitis)
- Back pain and stiffness, worse in the morning
- Nail changes, such as pitting, ridges or the nail lifting
- Fatigue
- Red, painful eyes in some people
Sore joints slowing you down?
Talk it through with an Australian doctor online. No referral needed.
How is it diagnosed?
There’s no single test. A doctor looks at your joints, skin, nails and family history. Blood tests are usually negative for rheumatoid factor and may show inflammation. X-rays, ultrasound or MRI can show inflammation or joint changes. A rheumatologist usually confirms the diagnosis.
Treatment
Treatment aims to control inflammation in the joints, tendons, spine and skin, and to prevent damage. International recommendations from the GRAPPA group tailor treatment to which parts of the body are affected. It usually involves:
- medicines that calm the immune system, managed by a rheumatologist, sometimes together with a dermatologist
- exercise and physiotherapy to keep joints and the spine moving
- managing related conditions, such as heart health, weight and mood
- stopping smoking
Why early treatment matters
PsA can cause permanent joint damage if inflammation isn’t controlled. If you have psoriasis and develop joint pain, swelling or stiffness, it’s worth getting checked early.
When to see a GP
See a GP if you have psoriasis, or a family history of it, and notice swollen joints, a sausage-like finger or toe, heel pain or morning stiffness.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Ritchlin CT, Colbert RA, Gladman DD. Psoriatic Arthritis. N Engl J Med. 2017;376(10):957-970.
- Coates LC, Soriano ER, Corp N, et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021. Nat Rev Rheumatol. 2022;18(8):465-479.
- healthdirect. Psoriatic arthritis.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.