Psoriatic arthritis (inflammatory joint disease)
Psoriatic arthritis is a chronic, rheumatic joint disease that affects approximately 1/3 of those with the skin condition psoriasis. Psoriasis is a skin disease that causes a characteristic red rash with dead skin - most often seen on the elbows, knees, ankles, feet, hands, scalp and other areas. Feel free to follow and like us too via social media. We also kindly ask that you - if desired - share the article on social media for increased understanding, focus and more research on rheumatic disorders. Many thanks in advance to everyone who shares - it can make a big difference for those affected.
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In this overview article we address the following categories:
Different types of psoriatic arthritis
Risk factors for psoriatic arthritis
Symptoms of psoriatic arthritis
Diagnosis of psoriatic arthritis
Treatment of psoriatic arthritis
Psoriatic arthritis and diet
What are the different types of psoriatic arthritis?
There are five different variants of psoriatic arthritis. In order to optimize treatment and measures, it is important to find out which variant you have.
Symmetric psoriasis arthritis
This type affects the same joints - but on both sides of the body. There are often several joints that are affected and the condition can be devastating in relation to everyday function due to progressive destruction of joints. Up to 50% with this type of arthritis are affected so severely that everyday chores can become very difficult. In many ways, symmetrical psoriatic arthritis is reminiscent of arthritis rheumatic arthritis.
Asymmetric psoriasis arthritis
This variant normally affects one to three joints in the body - which can be both large and small joints - for example the knee joints, the hip or the fingers. The joints are hit on one side of the body and not the other - in an asymmetrical pattern.
DIP-joint psoriasis arthritis
The DIP joints are the name of the small outer joints of the fingers and toes. This variant of psoriatic arthritis affects - hence the name - primarily these joints. Due to its similarities with osteoarthritis - which also normally affects the DIP joints - it is often misdiagnosed.
Spondylitis affects the spine and causes inflammatory reactions, as well as stiffness, in the neck, lower back, vertebrae and pelvic joints (iliosacral joints). These inflammatory reactions also limit the joints' natural range of motion. Spondylitis can also attack connective tissue - such as ligaments and tendons.
This variant of psoriatic arthritis is the most devastating version - causing severe, progressive destruction of joints - then primarily the smaller joints of the fingers and toes. Often it also leads to pain in the lower back and neck. Fortunately, this type of psoriatic arthritis is also the rarest.
Who is affected by psoriatic arthritis?
Between 10-30% of those with the skin disorder psoriasis suffer from psoriatic arthritis. The joint disease affects women and men equally often - and the disease can develop at any age, but usually affects people aged 30-50 years. The actual cause of the disorder is still not completely known, but it is believed that it is due to genetic and autoimmune factors. Psoriatic arthritis occurs mainly 10 years after the first signs of psoriasis, usually between the ages of 30 and 55.
As many as 40% of those with psoriatic arthritis have a family history of skin or joint disease. Having a parent with psoriasis triples the chance of developing psoriasis and psoriasis arthritis yourself.
What Causes Psoriasis Arthritis?
We must keep in mind that psoriasis is closely linked to psoriatic arthritis - that is, factors that increase the chance of skin disease also directly contribute to increasing the chance of joint disease as well. Certain risk factors can cause or exacerbate psoriasis. Here is a list of some of them:
Injury to the skin: Skin infection or excessive itching on the skin may be linked to increased incidence of psoriasis.
Sunshine: Most people feel that sunshine has a positive effect on their skin condition - but a small group experience that sunlight makes the condition worse. Getting sunburned in particular can lead to stronger psoriasis symptoms.
HIV: This diagnosis causes more frequent occurrence of psoriasis and skin symptoms.
Medications: A number of medications have shown promising properties above this skin disorder, including. beta blockers, malaria tablets, and lithium.
Stress: Many people who suffer from psoriasis notice a marked deterioration if they are very stressed emotionally.
smoking: Those who smoke have an increased chance of being affected by chronic psoriasis.
Alcohol: Drinking alcohol is a significant risk factor for psoriasis.
Hormonal changes: Hormones can regulate psoriasis and how severe it is - for example, the time immediately after a birth can lead to a sharp deterioration for certain people.
Symptoms of psoriatic arthritis
Psoriatic arthritis, like Bekhterevs / ankylosing spondylitis, is a seronegative spondyloarthritis. This means that no rheumatoid factor is found during testing. Psoriatic arthritis can cause several symptoms and clinical findings, including sacrolitis (inflammatory inflammation of the pelvic joint), swelling of the finger joints and general joint swelling and heat above the joint when touched. The disease can affect several joints and will normally worsen over time.
Psoriatic arthritis is a progressive, rheumatic joint disease that often causes swelling in the affected joints - such as the knees, ankles, feet and / or hands. Normally, several joints can be inflamed at the same time - and then they will be swollen and painful, as well as red and hot. If the fingers are affected, this can lead to so-called «sausage fingers».
As with other arthritis, the stiffness in the joints is usually worst in the morning. In symmetrical psoriatic arthritis, joints on both sides of the body will be affected at the same time - for example, both knees or both your elbows.
Increased Incidence of Joint Pain in Neck and Back
Due to inflammatory reactions in the joints, this can also cause pain and stiffness in your neck, upper back, lower back and pelvic joints. The worst variant of psoriatic arthritis, arthritis mutilans, can also cause severe bone and joint death. As mentioned earlier, this can lead to major dysfunctions in the hands and feet - both of which can go beyond everyday functions and chores. Things like keeping your balance when walking or opening a jam lid can be virtually impossible if you are severely affected by this variant.
In psoriatic arthritis, tendons can also be affected by inflammatory reactions - and especially the Achilles tendons on the back of the heel attachment. In such an inflammation, going up stairs can be extremely painful.
Nails on toes and fingers
A characteristic clinical sign of psoriatic arthritis is so-called "envelopes" on the nails - as shown in the picture below. In English, this symptom is called "pitting".
Inflammatory reactions in the colored part of the eye - the iris - can cause pain that gets worse in bright light.
Chest, lungs and heart
Rare symptoms of psoriatic arthritis can include breathing problems and chest pain. This can occur if the cartilage that attaches the ribs to the sternum becomes inflamed and irritated. And even less often, the lungs can be affected.
Diagnosis: How is psoriatic arthritis diagnosed?
Due to the fact that prolonged inflammatory processes in the joints can lead to destruction and degradation, it is important to get the condition diagnosed early and then take the measures and any medications that are recommended. This is often about NSAIDS (non-steroidal, anti-inflammatory drugs), as these can help slow down the development of the symptom picture.
The clinician will rely on your patient history and clinical presentation. A physical examination can provide useful information, but the tangible signs can be found via blood tests and imaging. In psoriatic arthritis, the antigen HLA-B27 will normally be found in blood tests. Psoriatic arthritis can be difficult to distinguish from other spondyloarthritis.
In addition to the mentioned symptoms, skin changes and nail changes will also be revealing if you are affected by psoriasis - and this provides a basis for further research.
X-ray and MRI images
Initially, radiographs will be taken to see if there are any structural or inflammatory changes in the vertebrae, endplates or pelvic joints. If the radiographs are negative, ie without findings, MRI images can be requested, as these are often more accurate and can see previous changes.
Blood lowering (ESR) provides a general basis for how much inflammation you have in your body - which in turn may be due to psoriatic arthritis. Higher levels of ESR can also be due to infection, cancer, liver disease or pregnancy.
Rheumatoid factor (RF) and antibody tests can help rule out rheumatic arthritis. Over half of those with psoriatic arthritis will have a positive impact on HLA-B27.
Psoriatic arthritis can cause bone loss - so a bone density measurement can be beneficial in ruling out osteoporosis or an increased risk of fractures.
Treatment of psoriatic arthritis
This inflammatory joint disease can affect your body on the outside and inside. The main purpose of treating this condition is to curb the inflammatory reaction that causes joint pain and pain. Anti-inflammatory drugs can relieve the pain and prevent further joint damage.
Medications can help you take control of joint disease - but if they do not, surgery may be the choice. The treatment is adapted based on how hard you are affected by psoriatic arthritis.
What medications help against psoriatic arthritis?
There is no cure for this disease, but medication and treatment can help slow development and relieve the symptoms. The main type of medication used in the medication of patients with psoriatic arthritis is anti-inflammatory drugs and painkillers (eg ibuprofen). If you have been diagnosed with psoriatic arthritis, it is important that you consult with your doctor about which medications you should take.
Medications are the treatment that has the greatest effect. However, physical therapy, massage, joint mobilization (eg chiropractic joint mobilization), electrotherapy (TENS), specific exercise programs and heat therapy work to relieve many patients.
If your arthritis is mild, this type of medication - such as naproxen, aspirin and ibuprofen - can help you. But unfortunately, what may be good for calming the inflammatory reactions in your joints is not very good for you. Side effects of taking NSAIDS include heart attack, stroke, stomach ulcers and bleeding - especially if you are taking medication for a long time.
A diet consisting of a lot of vegetables can lead to anti-inflammatory effects - which in turn can reduce the inflammatory reactions in the joints. In the same way, one should avoid sugar and alcohol, as these are pro-inflammatory and cause more inflammation.
Exercises and exercise increase blood circulation and can help against tight muscles and stiff joints. Physical treatment at a publicly licensed clinic such as a chiropractor, manual therapist or physiotherapist may also work as a symptom relief, as well as functional enhancement.
Gentle exercises for those with rheumatism (with video)
Here is a selection of customized exercises for those with fibromyalgia, other chronic pain diagnoses and rheumatic disorders. We hope you get the most out of them - and that you also choose to share them (or the article) with acquaintances and friends who also have the same diagnosis as you.
VIDEO - 7 Exercises for Rheumatists:
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Recommended Self-Help for Rheumatic and Chronic Pain
- Compression Noise (such as compression socks that contribute to increased blood circulation to sore muscles or specially adapted compression gloves against rheumatic symptoms in the hands)
- Mini tapes (many with rheumatic and chronic pain feel that it is easier to train with custom elastics)
- Trigger point Balls (self-help to work the muscles on a daily basis)
- Arnica cream or heat conditioner (many people report some pain relief if they use, for example, arnica cream or heat conditioner)
- Many people use arnica cream for pain due to stiff joints and sore muscles. Click on the image above to read more about how arnicakrem can help relieve some of your pain situation.
Next page: 9 Early Signs of Psoriatic Arthritis
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Frequently asked questions related to this article
Is Psoriasis Arthritis Dangerous?
Do children have the option of having psoriatic arthritis?
What are the possible causes of psoriatic arthritis?
What is the cause of psoriatic arthritis?
Can alcohol cause psoriatic arthritis?
- FarragherTM, Lunt M, Plant D, Bunn DK, Barton A, Symmons DP (May 2010). "Benefit of early treatment in inflammatory polyarthritis patients with anti-cyclic citrullinated peptide antibodies versus those without antibodies.".Ann. Rheum. Haze. 62 ( two: 10.1002 / acr.20207.