Warning Signs Of Psoriatic Arthritis
Psoriatic arthritis is a type of arthritis that affects 30% of people with psoriasis, according to the National Psoriasis Foundation. With PsA, your immune system attacks your own body, especially the skin and joints. PsA can mimic other forms of arthritis, such as gout, rheumatoid arthritis and osteoarthritis, says Dr. H. Kevin Jones, FAAOS,, a board-certified orthopedic surgeon at Beaufort Memorial Orthopaedic Specialists. Blood tests can point to other similar conditions and check for signs of inflammation. We can also order X-rays to look for bone and joint changes.
Symptoms Of Disease Progression
Rheumatoid arthritis is a chronic, progressive disorder. Unless the underlying inflammation can be brought into remission, the disease will continue to advance, causing not only pain and stiffness but undermining the integrity of the joint itself.
Over time, the relentless autoimmune response can deteriorate joint cartilage, erode bone tissue, and cause the bonding of joints, further restricting the range of motion. This is especially true of weight-bearing joints in which damage can result in the loss of mobility, such as the knees.
Edema, the swelling of tissue caused by fluid retention, is also common. With rheumatoid arthritis, swelling is typically associated with inflamed joints of the feet, ankles, legs, arms, and hands.
Eventually, as their structural underpinnings are destroyed, the joints will begin to lose their shape and alignment, resulting in joint deformity.
Common examples of this include:
- Ulnar deviation: Deformity of the big joints in the knuckles
- Joint contracture: The restrictive foreshortening of muscles around a joint
- Wrist subluxation: Dislocation and misalignment of the wrist bones
It is usually at this stage that other, more potentially serious complications can develop.
Does It Run In Families
You cant pass reactive arthritis on to your children. However, they can inherit the HLA-B27 gene, which could slightly increase their chance of getting the condition. This doesnt mean that by having this gene theyll definitely get reactive arthritis. However, the condition tends to be more common in people with HLA-B27.
Around 1 in every 10 people in the UK carry this gene.
The first signs of reactive arthritis are often:
- painful and swollen joints, usually in the ankles or knees
- sausage-like swelling of fingers or toes
- puffy, sore, red eyes, often with a mucus discharge known as conjunctivitis
- extreme, unexplained tiredness, known as fatigue
You may notice that your knees, ankles or toes suddenly become swollen, stiff and painful to move. Or the swelling may appear gradually over a few days.
Reactive arthritis can also affect other joints, such as your fingers, wrists, elbows and the joints at the base of your spine, known as the sacroiliac joints . It can also cause inflammation in the tendons around your joints, such as the Achilles tendon which runs down the back of your ankle.
You may find your whole finger or toe swells up if both the tendons and joints become affected at the same time. This is often called sausage digit or dactylitis .
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Why Do My Hands Hurt: Arthritis And Other Culprits
Do you find that sometimes you get an achy feeling in your fingers or wrist? Do you have trouble moving your fingers or gripping things? It might just feel tingly, or it might be a burning pain. It comes and goes, so youre not sure whether to worry about it. You just wonder: Why do my hands hurt? Here are three possible culprits for your hand pain and how to address them.
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How To Better Manage Psoriatic Arthritis Right Now
One unique symptom of psoriatic arthritis that doctors look for is the presence of psoriasis, a condition that causes thick, discolored, scaly skin patches known as plaques, as well as pitted nails or nails that separate from the nail bed, according to the American Academy of Dermatology.
Like psoriatic arthritis, psoriasis stems from a faulty immune response, in which the immune system mistakenly attacks healthy cells and tissues.
About a third of people with psoriasis develop psoriatic arthritis, according to the Arthritis Foundation. About 10 percent of people develop arthritis first, then psoriasis later, says Eric Ruderman, MD, a rheumatologist at Northwestern Memorial Hospital in Chicago.
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Prognosis Of Psoriatic Arthritis
Estimating prognosis in PsA is difficult due to a lack of evidence and significant individual variability. PsA can evolve over time with variable joint and extra-articular involvement, according to multiple investigations. The pattern of peripheral joint disease appears to evolve with time, with oligoarthritis being more common in early disease patients than late disease individuals. In majority of the cases, increasing disease duration leads to increased joint involvement, with a large proportion of individuals with monoarthritis or oligoarthritis progressing to polyarthritis. Axial involvement becomes more likely as the disease progresses.1
PsA is a disease that can cause severe morbidity and have a negative impact on patients quality of life. Some characteristics are thought to indicate a severe disease course and a poor prognosis. A high number of actively inflamed joints or polyarticular presentations, raised ESR, clinical or radiographical damage, loss of function and a lower quality of life are all indicators.11
Arthritis In The Big Toe
Arthritis in the big toealso called hallux rigidusis common. It typically affects the first metatarsophalangeal joint, which is located at the base of the big toe and connects the toe to the rest of the foot. Every time you take a step, this joint bears your body weight arthritis in this joint can increasingly limit your ability to walk without pain.
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What Are The Signs And Symptoms Of Arthritis Of The Knee
There are many signs and symptoms of arthritis of the knee:
- Creaking, clicking, grinding or snapping noises .
- Difficulty walking.
- Joint pain that changes depending on the weather.
- Joint stiffness.
- Knee joint pain that progresses slowly or pain that happens suddenly.
- Your knee locks or sticks when its trying to move.
Pain and swelling are the most common symptoms of arthritis of the knee. Some treatments might reduce the severity of your symptoms or even stall the progression. See your healthcare provider if you have symptoms of knee arthritis.
Focusing On People With Psoriasis
Most people with psoriatic arthritis have psoriasis first. For a small percentage of patients, psoriatic arthritis occurs before psoriasis, although most often they will have a first-degree relative with skin psoriasis, notes Dr. Haberman. Still, others have no skin psoriasis or dont notice the psoriasis hidden in areas like the scalp, umbilicus, and gluteal fold.
Read more about the connection between psoriasis and PsA.
Up to 30 percent of patients with psoriasis will go on to develop psoriatic arthritis, says Dr. Haberman. The majority of cases begin with the skin condition and then progress to joint pain within seven to 10 years. Recent studies have found that patients with psoriasis who develop severe fatigue, heel pain, and joint pain without overt swelling are more likely to develop PsA.
While we dont yet know which individual patients with psoriasis will go onto develop PsA, researchers have identified a few potential risk factors for the progression of PsA, including:
- Family history of psoriatic arthritis
- Psoriasis that affects the scalp and groin
- Nail involvement in psoriasis, such as nail pitting
- Being overweight or obese. PsA is worse in patients who are overweight and often biologics may not work as effectively in people who are overweight, says Dr. Haberman.
- Exposure to certain infections
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When To Contact A Doctor
Below are guidelines to help people decide if their knee swelling requires medical attention. If the person is still unsure whether to seek professional medical treatment, a phone call to a doctor or nurse can help determine whether an office visit is necessary.
A doctor should be contacted if:
- The knee is severely swollen or has a pronounced abnormality
- The knee cannot fully straighten or fully bend
- The knee is severely painful
- The person cannot bear weight on the knee, or feels as if the knee is going to give out
- The skin over the knee turns hot or red
- The person has a fever of 100.4° F or higher
- Knee swelling has been present for 3 days or longer
A doctor will examine the patients knee and ask the patient several questions. The physical examination and patient interview may provide enough information to make an accurate diagnosis. If more information is needed, the doctor may recommend medical imaging, such as an x-ray, or removing fluid from the knee using an in-office procedure called aspiration.
Seek immediate care if the leg swelling occurs suddenly with no known reason, particularly if it is accompanied by symptoms such as leg pain, chest pain, and/or problems breathing, as these may be signs of a life-threatening blood clot.
Can Arthritis Cause Numbness
Numbness is often a symptom of nerve involvement. For instance, numbness in the arm may be related to nerve irritation in the neck. In such a situation, turning or bending the head to the involved side may increase the symptoms. For example, a pinched nerve in the right side of the neck may cause numbness in the arm and hand when a person attempts to look back over the right shoulder. If nerve irritation becomes more severe, the arm and hand may become weak. A physical examination X-rays and an MRI of the neck and electrodiagnostic tests may be useful in establishing the diagnosis.
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How Can I Prevent Arthritis In My Feet
Although it may be impossible to prevent arthritis from developing, the conditions that lead to it can be corrected. For instance, if you have osteoarthritis, correcting any faulty mechanics that lead to the joint not moving properly may prevent further joint damage.
Wearing proper footwear or custom orthotics prescribed by your podiatrist will ensure that the foot and ankle joints are properly aligned. If you have a rheumatic disease, such as gout, controlling your uric acid level can reduce the incidence of the associated arthritis.
What Are The Symptoms Of Swollen Legs
Having âswollen legsâ is a symptom itself, but legs can be swollen in different ways. The clue to the cause may well be in the type of swelling. The swelling can be:
- One-sided or both-sided. Oedema due to conditions of general body systems is usually on both sides and is symmetrical One-sided swelling is more likely to be due to a problem with a particular part of that leg.
- In a specific area or generalised. Swelling around joints is usually caused by injury or a type of arthritis. Swelling in specific areas of skin may be caused by allergy or infection. Swelling around the back of the heel suggests a problem of the Achilles tendon, etc. Generalised swelling, especially if on both sides, is likely to be oedema.
- Painful or painless. Painful conditions include infections, deep vein thrombosis , injuries and joint problems. Oedema is not usually painful, although legs can ache and feel tight.
- Accompanied by red or normal skin colour. If the skin is reddened, it is likely to be due to an infection , or inflammation .
- Pitting or not. Pitting means that if you press a fingertip into the swollen area and then take your fingertip away, a dent remains in the skin. Oedema tends to be pitting. Lymphoedema, a condition where there is a blockage to lymph fluid, does not usually pit so much.
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Symptoms Of Arthritis In Your Feet
Like most other cases of arthritis, having arthritis in your feet can be painful. Some of the most common symptoms include the following:
- Pain when you move your feet or ankles
- Tenderness when you touch affected joints
- Swelling or redness of affected joints
- Difficulty standing or putting pressure on your feet
- Pain or swelling even when at rest
While these symptoms can give you a pretty good idea that you have arthritis, the best way to know for sure is to have a doctor take a look. Your doctor may use imaging technology, such as an MRI, X-rays, or CT scans, to confirm that you have arthritis in your feet or ankles.
Gout And Calcium Crystal Diseases
Gout is a type of inflammatory arthritis that can cause painful swelling in joints. It typically affects the big toe, but it can also affect other joints in the body.
Joints affected by gout can become red and hot. The skin may also look shiny and can peel.
Its caused by having too much urate, otherwise known as uric acid, in the body. We all have a certain amount of urate in our body.
However, being overweight or eating and drinking too much of certain types of food and alcoholic drinks can cause some people to have more urate in their bodies. The genes you inherit can make you more likely to develop gout.
If it reaches a high level, urate can form into crystals that remain in and around the joint. They can be there for a while without causing any problems and even without the person realising they are there.
A knock to a part of the body or having a fever can lead to the crystals falling into the soft part of the joint. This will cause pain and swelling.
There are drugs that can reduce the amount of urate in the body and prevent gout attacks. Examples are allopurinol and . If youre having a gout attack, youll also need short-term pain relief. Non-steroidal anti-inflammatory drugs as well as paracetamol can be good drugs to try first.
Men can get gout from their mid-20s, and in women its more common after the menopause. Taking water tablets can increase the risk of gout.
There are also conditions that cause calcium crystals to form in and around joints.
Can Psoriatic Arthritis Affect Children Too
As many as 12,000 children in the UK are affected by arthritis. It is known as juvenile chronic arthritis , of which there are three main types, stills disease, polyarticular juvenile chronic arthritis and polyarticular onset juvenile chronic arthritis. Psoriatic arthritis is a minor subset of JCA and is uncommon.
Tips To Reduce Your Risk Of Infection
- Try to avoid close contact with people you know have an infection.
- Wash your hands regularly and carry around a small bottle of antibacterial hand gel.
- Keep your mouth clean by brushing your teeth regularly.
- Stop smoking if youre a smoker.
- Make sure your food is stored and prepared properly.
- Try to keep your house clean and hygienic, especially the kitchen, bathrooms and toilets.
If you are prescribed a drug you may find more information about it here.
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What Outcome Can I Expect If I Have Arthritis In My Hands
There is no cure for arthritis. However, you can usually manage mild to moderate symptoms with a combination of medication and non-medication approaches. Surgery may be an option if other treatments fail or the arthritis in your hands is severe. Your healthcare provider will explain what outcome you can expect for your type and severity of arthritis, your age, other existing medical conditions and other factors.
Loss Of Significant Joint Mobility
For example, you were able to flex your wrist 60 degrees, and two years later, you lost 50 percent of that range of motion. Its possible to feel okay and still experience loss of range of motion, says Dr. Domingues. But the idea is to prevent joint damage and to make you have less pain. If you have less pain and are still progressing, that means your treatment could be working better.
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Diagnosing And Treating Arthritis
Over time, arthritis can change the joint, says Dr. Joyner. Sometimes you can see these changes, like knobby fingers, but usually you can only see the damage in an X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints.
To diagnose arthritis, a doctor will ask you about your medical history and give you a physical exam. They may also do blood tests or take X-rays. It is possible to have more than one form of arthritis at the same time. For most forms of arthritis, the earlier youre diagnosed, the better. Early treatment can help you prevent or reduce more severe symptoms as you age.
- Reduce the amount of joint damage
- Improve or maintain how well you move
When possible, exercise is good for managing arthritis. It can decrease the amount of pain and stiffness you feel, increase your strength, give you more energy and preserve both your joint function and mobility.For inflammatory arthritis, treatment also includes controlling the inflammation with medications or physical therapy. Sometimes, surgery is needed.
Conditions Associated With Pain Behind The Knee
Two common conditions that cause pain behind the knee are:
- a popliteal cyst, also called Bakers cyst
- posterior cruciate ligament injury
A cyst is a collection of fluid inside a thin layer. A popliteal cyst is a cyst in the shallow depression at the back of the knee. Its often linked to other conditions affecting the knee, including osteoarthritis, rheumatoid arthritis, cartilage injuries and inflammation of the knee joint. Many types of injury can cause a collection of fluid. Often it will be a heavy blow to the front of the knee, from falling forwards or playing a contact sport. The natural mechanism of the knee pushes this excess fluid backwards and it collects in the depression at the back of the knee, over time, causing a cyst to form.
A posterior cruciate ligament injury is caused by overstretching or tearing of this ligament, which runs across the knee from the thigh to the shin bone. It often results from a heavy blow to the front of a bent knee, sometimes from falling forwards or during a contact sport, such as rugby. Other typical injuries can occur when the knee hits the dashboard during a car accident or when the leg is over-straightened and the knee is bent backwards. Doctors call this hyperextension.
You can access a range of treatments on a pay as you go basis, including physiotherapy. Find out more about physiotherapy >
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