Definition of Psoriatic Arthritis
Psoriatic arthritis is a type of chronic inflammatory arthritis. It is often mistaken for gout. Psoriatic arthritis affects about 50% of all patients suffering from psoriasis. Psoriasis is an autoimmune disease that presents with skin manifestations and associated arthritis.
Psoriatic arthritis, being an inflammatory disease, tends to share several disease features under the category of inflammatory arthritis. These include: rheumatoid arthritis and Ankylosing spondylitis.
Causes of Psoriatic Arthritis
Psoriatic arthritis is an autoimmune type of arthritis. As with many autoimmune types of arthritis, psoriatic arthritis is a result of deposition of immune complexes in the joint capsule. Formation of immune complexes is as a result of the body’s immune system attacking itself. Research has not been able to pinpoint the trigger factors that cause the immune system to attack itself.
Some studies have suggested that approximately 40% of individuals developing psoriatic arthritis have a family history of the disease. The hereditary link requires further investigation. There seems to be no gender discrimination in psoriatic arthritis. It is commonly diagnosed in people between the ages of 30 and 50 years of age, although cases of childhood psoriatic arthritis have been reported.
Symptoms of Psoriatic Arthritis
The clinical presentation of psoriatic arthritis varies from person to person which is why it is mistaken for rheumatoid arthritis, gout or sometimes osteoarthritis. To avoid this confusion, rheumatologists decided, after a number of yielding studies, to conclude on the following patterns of psoriatic arthritis to capture the diversity of its symptomatology:
- Asymmetrical oligoarticular arthritis: is about 40% of all cases of psoriatic arthritis. Commonly present in the joint of the back and legs such as the sacroiliac joint, hip joint, knee joint, joints of the toes. Oligoarthritis is defined as involvement of more than one joint but less than three joints. The joint is typically stiff with localized redness and increased warmth. Joint swelling is common.
- Symmetrical polyarticular arthritis: is the most common type of psoriatic arthritis. A person may exhibit symptoms of arthritis in more than 3 joints at once i.e. pain in both knees, stiffness in the hip joint, swelling in the wrist joints and limited mobility in the elbow joint. This pain from this type of arthritis can be overwhelming to a person and is the reason for seeking medical attention.
- Distal Interphalangeal arthritis: this involves the joints near the nails of the hands and feet. Finger and toe disfigurement is common with associated pitting and waterspots on the fingernails.
- Arthritis mutilans: least common. Found in less than 5% of psoriatic arthritis cases. Typically found on the small joints e.g. hand and feet joints.
- Spondylitis: mainly causes back pain, stiffness and diminished upper body movements. Spondylitis is inflammation of the spinal joints.
Treatment of Psoriatic Arthritis
Getting an orthopedic specialist who is familiar with the dynamics of psoriatic arthritis goes a long way in preventing the onset of disability. Early diagnosis is pivotal. Dr. Burke, our orthopedic surgeon, who has helped thousands of patients with psoriatic arthritis, possesses the clinical skills necessary in establishing a diagnosis of psoriatic arthritis in its very early stages. He uses the following therapeutic modalities to ensure optimum affectivity:
- Oral Steroids, injectable steroids
- DMARDs e.g. sulfasalazine, methotrexate, azathioprine etc.
- Heat and cold therapy
- Physiotherapy and exercise
- Orthotics and other assistive devices
- Arthroscopy-guided joint debridement
- Hip replacement