Wednesday, December 6, 2023

What Joints Are Affected By Psoriatic Arthritis

Can Psoriatic Arthritis Cause Hearing Loss

Is That Joint Pain Psoriatic Arthritis?

Studies have looked at hearing in people with psoriatic arthritis. Researchers have found that hearing loss is more common in psoriatic arthritis patients compared to those without the disease.

One group of researchers used data from NHANES to look at the link. They compared people of the same age with and without psoriatic arthritis to control for age-related hearing loss. They found psoriatic arthritis patients were more likely to report problems with their hearing. But this type of study is limited because it only describes what is going on in a population. It cant show cause and effectif psoriatic arthritis causes hearing loss.

Other researchers have conducted case-control studies on the link. A case-control study directly compares people with a disease to those without it. It aims to see if the disease is associated with a certain outcome.

They matched people for age. But they actually tested hearing levels instead of only relying on people reporting hearing problems . The results were striking. About 60% of people with psoriatic arthritis had measurable hearing loss compared to only 8.3% of those without the disease. Whats more, about 23% of patients had problems with balance compared to none without the disease. When researchers looked at inner ear tests, 27% of psoriatic arthritis patients had inner ear damage. None of the controls showed damage.

Do We Know What Causes Psoriatic Arthritis

  • The cause of psoriatic arthritis is the subject of much research.
  • You cannot catch psoriatic arthritis or psoriasis from someone else. Therefore they are not contagious.
  • The cause of psoriatic arthritis is not proven but experts believe it to be a combination of genetic, immunological and environmental factors. 2 out of 5 people with psoriasis or psoriatic arthritis have a first-degree relative with the condition. This means you have a higher chance of developing psoriasis or psoriatic arthritis if you have relative who has the condition. Some experts believe infections such as streptococcal infections may provoke psoriatic arthritis, though this is not proven.
  • The role of bacteria in the gut and developing psoriatic arthritis is the subject of current research.
  • Trauma and stress may be contributing factors, although this is not proven.
  • The genetic make-up of an individual is likely to determine the risk of developing psoriasis and psoriatic arthritis and probably influences the severity.
  • Being overweight is now understood to be linked to developing psoriatic arthritis and is the subject of ongoing research.
  • There are certain genetic markers linked to the immune system which are now being used to predict the severity of psoriatic arthritis. Much more is known about the mechanisms that lead to inflammation in other conditions and it is likely advances in science will lead to much more effective treatments with fewer side effects.

How Does Psa Affect The Knees

Symptoms of PsA in the knees include stiffness, especially first thing in the morning or after a period of rest, joint pain, swelling, and reduced range of motion. One or both knees may be affected in a person with PsA. PsA is frequently asymmetrical, affecting only one side of the body. For example, PsA may involve the right knee while the left knee is unaffected. PsA can also be symmetrical, affecting both sides of the body, such as both legs at the same time.

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How Is Psoriatic Arthritis Diagnosed In A Child

Psoriatic arthritis is easier to confirm if your child already has psoriasis. If the skin symptoms have not yet occurred, diagnosis is more difficult. Your childs healthcare provider will take your childs medical history and do a physical exam. The provider will ask about your child’s symptoms. Your child may have blood tests such as:

  • Erythrocyte sedimentation rate . This test looks at how quickly red blood cells fall to the bottom of a test tube. When swelling and inflammation are present, the blood’s proteins clump together and become heavier than normal. They fall and settle faster at the bottom of the test tube. The faster the blood cells fall, the more severe the inflammation.

  • Uric acid. High blood uric acid levels are linked to psoriatic arthritis.

  • Complete blood count . This test checks for low counts of red blood cells , white blood cells, and platelets.

  • Antibody blood tests. These tests are done to look for certain kinds of proteins, called antibodies, in your blood. These tests can be positive for many kinds of rheumatic diseases. Younger children are more likely to have a positive antinuclear antibody test.

Other tests may include:

  • X-rays. This test uses a small amount of radiation to create images of organs, bones, and other tissues.

  • Eye exam. This is done by a pediatric eye doctor . The exam looks for uveitis, a swelling of the middle layer of the eye.

Signs And Symptoms Of Psoriatic Arthritis

Psoriasis &  Psoriatic Arthritis

In psoriatic arthritis, the joints affected may become tender, swollen and stiff. These symptoms tend to be worse first thing in the morning and with rest, and ease with exercise. Inflammation of tendons without obvious inflammation of the joints can also occur in psoriatic arthritis, which makes it easy to misdiagnose as tendonitis or tennis elbow, for example. Psoriatic arthritis commonly affects the small joints of the hands and feet, and so a swollen sausage-like finger or toe is another common sign.

  • Stiffness, pain, throbbing, swelling and tenderness in one or more joints
  • Swollen sausage-like finger or toe
  • Nail changes
  • Tenderness, pain and swelling over tendons
  • A reduced range of movement
  • General tiredness

Nail psoriasis is seen in a large number of people with PsA, so this can also be a good indicator. Like psoriasis, PsA can wax and wane, so people with the condition may find that their symptoms get better and worse over time.

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Presentations Of Psoriatic Arthritis

Psoriatic arthritis causes swelling, pain and stiffness in your joints and in areas where your tendons and ligaments connect to bone.

Just like psoriasis, PsA can range from mild to severe. Mild PsA is sometimes referred to as oligoarticular, meaning it affects four or fewer joints in the body. More severe PsA is often called polyarticular, meaning it affects five or more joints. But regardless of the severity, psoriatic arthritis can have a profound impact on pain, the ability to do daily tasks and move comfortably.

PsA can involve the peripheral joints or less commonly, the axial skeleton .

How Joints Are Affected By Psa

In some people, PsA only affects a few joints. In others, PsA affects many joints in the body. The wide variation in how the disease appears in different people is part of what makes diagnosis a challenge. Experts categorize the joint involvement in PsA as:

  • Oligoarticular Oligo means few. Oligoarticular PsA affects only a few joints, generally less than or equal to four.1,3 Large joints, hands, or feet can be involved, and this pattern usually occurs in men.3
  • Polyarticular symmetric/asymmetric Poly means many. Polyarticular PsA affects more than four joints and can affect both sides of the body or just affect one side of the body .1,3
  • Distal interphalangealpredominant PsA may concentrate in the joints of the fingers or toes. This form of PsA is more likely to have nail involvement.1 DIP may be symmetric or asymmetric and may affect a few joints or many. It commonly leads to progressive bone destruction.3
  • Axial disease, also called spondylitis PsA can impair the joints between the vertebrae in the spine.1
  • Arthritis mutilans The most severe form of PsA, arthritis mutilans is characterized by the destruction of the bony tissue in the distal joints, causing deformed shortening of the fingers or toes. 1,3,4 Arthritis mutilans occurs in up to 5% of PsA cases.3

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What Is Psoriatic Arthritis In Children

Psoriatic arthritis is a rare form of arthritis or joint inflammation that affects both skin and joints. Psoriasis is an ongoing condition that causes a red, scaly, itchy rash. It also causes nails to become thick and pitted with tiny holes.

Psoriatic arthritis causes painful joint pain and swelling, along with skin rashes. It most often affects finger and toe joints. But it can also affect wrists, knees, ankles, and the lower back.

This condition is most common in adults ages 30 to 50. But it can start in childhood. In many cases, the skin disease starts before the arthritis.

Early diagnosis and treatment helps to ease pain and prevent joint damage from getting worse.

As Can The Words Youre Too Young To Have Arthritis

Permanent joint damage in psoriatic arthritis

When you say the word arthritis, every older person you meet has it, too, Dishner says. While well-meaning people may sympathize by comparing their own ailment with yours, psoriatic arthritis is a much different form of arthritis and does not develop because of aging. It can occur at any age but typically begins to cause symptoms among those between 30 and 50 years old, according to the NPF.

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Occurrence In The United States

According to the National Psoriasis Foundation, psoriatic arthritis affects about 1 million people in the United States, or about 30% of all persons with psoriasis. However, prevalence rates vary widely among studies. In one population-based study, less than 10% of patients with psoriasis developed clinically recognized psoriatic arthritis during a 30-year period. A random telephone survey of 27,220 US residents found a 0.25% prevalence rate for psoriatic arthritis in the general population and an 11% prevalence rate in patients with psoriasis. However, the exact frequency of the disorder in patients with psoriasis remains uncertain, with the estimated rate ranging from 5-30%.

Moreover, since the late 20th century, the incidence of psoriatic arthritis appears to have been rising in both men and women. Reasons for the increase are unknown it may be related to a true change in incidence or to a greater overall awareness of the diagnosis by physicians.

What Joints Are Most Affected By Psoriatic Arthritis

Mainly occurs in the fingers , wrists, ankles and knees. Symptoms such as pain, tenderness, warmth and swelling, may affect different sides of the body . This may be referred to as peripheral arthritis.

Considering this, What does a psoriatic arthritis flare feel like? Often when a psoriatic arthritis flare-up begins, you feel very off. Personally, I feel like I have the flu. I get achy all over, chills, and feel like Im running a fever . This can feel very different in each of us, but a general feeling of discomfort and uneasiness is common.

What triggers psoriatic arthritis? Psoriatic arthritis occurs when your bodys immune system attacks healthy cells and tissue. The immune response causes inflammation in your joints as well as overproduction of skin cells. It seems likely that both genetic and environmental factors play a role in this immune system response.

Furthermore, Is psoriatic arthritis itchy? Psoriatic arthritis can cause different symptoms from person to person. But there are several common symptoms: Psoriasis and pitting of your nails. Painful, swollen joints, most commonly in your hands, feet, wrists, ankles and knees.

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What Is Psoriatic Arthritis

Psoriatic arthritis is a type of arthritis linked with psoriasis, a chronic skin andnail disease. Psoriasis causes red, scaly rashes and thick, pitted fingernails.Psoriatic arthritis is similar to rheumatoid arthritis in symptoms and jointswelling . But it tends to affect fewer joints than RA. And it does notmake the typical RA antibodies. The arthritis of psoriatic arthritis comes in 5forms:

  • Arthritis that affects the small joints in the fingers, toes, or both
  • Asymmetrical arthritis of the joints in the hands and feet
  • Symmetrical polyarthritis, which is similar to RA
  • Arthritis mutilans, a rare type of arthritis that destroys and deforms joints
  • Psoriatic spondylitis, arthritis of the lower back and the spine

How Can I Help My Child Live With Psoriatic Arthritis

Psoriatic Arthritis in the Feet: Symptoms, Treatment, Home Remedies

Help your child manage his or her symptoms by sticking to the treatment plan. This includes getting enough sleep. Encourage exercise and physical therapy and find ways to make it fun. Work with your childâs school to make sure your child has help as needed. Work with other caregivers to help your child take part as much possible in school, social, and physical activities. Your child may also qualify for special help under Section 504 of the Rehabilitation Act of 1973. You can also help your child find a support group to be around with other children with pediatric arthritis.

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Classification Of Psoriatic Arthritis

Psoriatic arthritis is a form of spondyloarthritis. Spondyloarthritis is an umbrella term used to describe a family of disorders, including ankylosing spondylitis, non-radiographic axial spondyloarthritis, psoriatic arthritis, reactive arthritis, enteropathic arthritis and undifferentiated spondyloarthritis. These different forms of spondyloarthritis share several clinical features:

  • Axial joint inflammation
  • Asymmetric oligoarthritis
  • Dactylitis: ‘sausage digits’
  • Enthesitis: pain and swelling at the insertion of tendons and ligaments, commonly at the heel, tibial tuberosity and humerus this affects up to 53% of patients with psoriatic arthritis
  • Negative Rheumatoid Factor
  • HLA-B27 positivity: HLA-B27 is a specific protein involved with immune regulation. 57% of psoriatic arthritis patients with axial involvement are positive for HLA-B27
  • Geneticsusceptibility to the condition/family history
  • Distinctive radiological features.

Beyond Joints: How Psoriatic Arthritis Affects The Body

This autoimmune, inflammatory disease can reach beyond skin and joints to attack organs and more.

Joint pain is a big part of living with psoriatic arthritis . But the inflammation that affects your joints can cause problems for other organs and tissues, too, and comorbidities, or conditions that often occur with PsA, including obesity and diabetes, bring additional effects not directly related to joints. Youll probably think of skin issues first, but your eyes, heart, lungs, gastrointestinal tract , liver and kidneys may also be affected.

Skin. Psoriasis appears first in 60% to 80% of patients, usually followed within 10 years but sometimes longer by arthritis. Some people are diagnosed with both diseases at the same time, and 10% to 15% have psoriatic arthritis symptoms before psoriasis. Psoriasis creates thick, reddish, inflamed patches of skin, often with silvery-white scales. These patches, which sometimes itch and burn, may appear anywhere on the body, but are most common on the elbows, knees, scalp, back, face, palms and feet. Its considered severe when more than 10% of the body is covered.

Lungs. The inflammation that causes PsA may also harm your lungs, causing a condition known as interstitial lung disease that leads to shortness of breath, coughing and fatigue. This condition occurs less frequently with PsA than with certain other rheumatic diseases, such as rheumatoid arthritis.

Last reviewed 4/21/2021

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What Organs Does Psoriatic Arthritis Affect

Due to widespread inflammation, psoriatic arthritis can affect your internal organs but this occurs only in very rare cases and should not be a major concern. More common symptoms to watch out for beyond joint pain and inflammation are fatigue and anemia, mood changes or depression, high blood pressure/cholesterol, diabetes, and obesity.

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What To Do About Your Symptoms

Whatâs Psoriatic Arthritis?

If youre experiencing any of the symptoms above and have psoriasis, seek help from your health care provider to consider a possible evaluation with a rheumatologist. Getting treatment early can help you avoid further joint damage and pain.

To find a Banner Health specialist near you, visit

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How To Treat Psoriatic Arthritis

The main goals in managing PsA are to stop disease progression, reduce inflammation, treat skin symptoms, relieve pain, and keep your joints moving as much as possible.11 A dermatologist and rheumatologist should coordinate your treatment plan. A physical therapist may also be helpful to help increase your flexibility and strength.11

For those people with psoriatic arthritis and psoriasis, your doctor will design a treatment plan that addresses both conditions.

The foundation of PsA treatment includes medications that control inflammation in the body and reduce pain. Medications may include the following and are usually recommended based on the severity of your PsA symptoms.

Mild Disease: The goal of treating mild PsA is primarily to ease pain and reduce inflammation. A number of anti-inflammatory drugs may be recommended, such as:

  • Nonsteroidal anti-inflammatory drugs : NSAIDs include drugs like ibuprofen and naproxen sodium that can be purchased over-the-counter as well as prescription-grade NSAIDS, such as celecoxib or diclofenac.
  • Corticosteroids: These are more powerful anti-inflammatory drugs that are prescribed by a doctor and can be taken either by mouth or injected in the doctors office. These medications are only used for brief periods of time for disease flare-ups because of their adverse long-term side effects.

What Is An Autoimmune Disease

Autoimmune disease happens when the bodys natural defense system cant tell the difference between your own cells and foreign cells, causing the body to mistakenly attack normal cells. There are more than 80 types of autoimmune diseases that affect a wide range of body parts.

According to the classification criteria of the Assessment of SpondyloArthritis international Society , inflammatory back pain typically lasts for three months or more with an insidious or unknown onset, begins in patients at an age younger than 40, improves with exercise but gets worse with rest, and causes increased pain at night.

Mechanical back pain, however, can have an onset at any age, although it is more common in middle-aged and older individuals, can be acute from a specific event that causes an injury, and often feels worse with movement but improves with rest. These symptoms can result from injury or damage to the lower back muscles, tendons, ligaments, discs, joints, or vertebrae.

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Common Symptoms Of Psoriatic Arthritis May Include:

Psoriatic arthritis typically affects the ankles, knees, fingers, toes, and lower backand can cause joint damage if not treated appropriately. People with PsA may experience joint pain, swelling, and tenderness in one or more joints, as well as stiffnessparticularly in the morning or after a period of rest.

The skin symptoms of psoriatic arthritis include a rash, thick, red skin, or flaky, silver-white scaly patches, as in plaque psoriasis. The skin may itch and be painful. Up to 85% of people with PsA experience skin problems associated with psoriasis before having psoriatic arthritis symptoms.

Many patients with PsA experience fatigue , which can be debilitating. PsA fatigue can be caused by ongoing inflammation, anemia , and other factors. Managing the level of inflammation can help reduce fatigue, so things like following an anti-inflammatory diet and talking to your doctor about your treatment goals may help.

“Sausage-like” swelling along the entire length of fingersalso called dactylitisis often a telltale sign of psoriatic arthritis. This is different from rheumatoid arthritis, in which the swelling is usually confined to a joint. In PsA, it is possible to have swelling in your hands and feet before developing joint symptoms.

Difficulty moving joints and limbs as freely as before is a sign of PsA.

In PsA, joints tend to be stiff and inflexible either first thing in the morning or after a period of rest.

The impact of psoriatic arthritis symptoms

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