Psoriatic Arthritis


Psoriatic arthritis (PsA) is a chronic inflammatory autoimmune condition characterized by inflamed joints. Psoriatic arthritis often, but not always, occurs in people who also have psoriasis, an autoimmune skin condition that results in scaly, red itchy patches. PsA can affect the large joints such as the knees and shoulders but also may also occur in joints like the fingers, toes, back or pelvis. Symptoms usually start between ages 30 and 50 and can lead to mild symptoms or chronic inflammation that may result in joint damage if not treated appropriately. Men and women are equally at risk.

What Are the Signs/Symptoms?

Psoriatic arthritis may affect one or many different joints, resulting in stiffness and swelling. Dactylitis or swelling of fingers and toes can be seen along with pitting of your nails. Other signs can include inflammation of the tendons called enthesitis, back pains, colitis, and uveitis (inflammation in your eyes). Diagnosing psoriatic arthritis starts with a physical exam to look for swollen or painful joints, and nail and skin changes. X-rays or scans like ultrasound, MRI or CT can show joint damage. Blood tests may help rule out other diseases, and a skin biopsy can confirm psoriasis.

What Are Common Treatments?

Treatments depend on the extent of pain, swelling or stiffness and aim to decrease pain and inflammation along with preventing long term joint damage. Mild arthritis flares may be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen sodium. Corticosteroid shots may ease pain and swelling in an affected joint. If NSAIDs don’t ease arthritis symptoms, your rheumatologist may prescribe disease-modifying antirheumatic drugs (DMARDs), such as sulfasalazine, methotrexate, or leflunomide, or azathioprine. People with severe arthritis may try biologics, such as adalimumab, etanercept, infliximab. Other biologics used for psoriatic arthritis include secukinumab, ixekizumab, ustekinumab, guselkumab and abatacept. Oral medications, such as tofacitinib and apremilast have also been shown to be effective. Your rheumatologist will work with you to find the best treatment option for you.

Living with PsA

Maintaining regular follow up appointments with your rheumatologist to ensure proper disease control is essential for success in treatment of PsA. Regular exercise such as walking, biking, and yoga also help to keep joints strong and improves cardiac health. Follow up with your primary care doctor is also advised to monitor for high blood pressure, obesity, type-2 diabetes and high cholesterol. If you also have psoriasis, a dermatologist can treat with additional agents to improve skin disease.

Updated February 2023 by Bhakti Shah, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.

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