5 types of psoriatic arthritis: symptoms, diagnosis and more

Asymmetric PsA impacts one or more joints on one side of your body. Typically, less than 5 joints are impacted by this type of PsA. Asymmetric PsA is more common in assigned males at birth.

The Arthritis Foundation notes that most of the time, PsA is asymmetric. We think that about 60 percent individuals with PsA initially present with asymmetric PsA. But over time, this can evolve into symmetrical PsA.

Any joint in the body can be affected by asymmetric PsA. Some areas that are most commonly affected are:

• knee
• feet
• fingertips and toes
• big joints

Symptoms

Symptoms of asymmetric RP can be mild to severe and may include:

The fact that asymmetric PsA affects only one side of the body can help distinguish it from other types of arthritis, such as rheumatoid arthritis (RA).

Symmetric PsA impacts five or more of the same joints on both sides of the body. Although this type of PsA can occur in any joint, the small joints of the hands and feet are most often affected. Symmetric PsA is less common in large joints.

The incidence of symmetrical RP is estimated to vary from 15 to 61 percent. Symmetric PsA is more common in persons assigned female sex at birth.

Symptoms

Symptoms of symmetrical RP are generally the same as those seen in asymmetric RP. They can also vary from mild to severe.

Because this type of PsA is symmetrical and mainly affects small joints, it can often be mistaken for RA. But it’s usually milder than RA, and blood tests for rheumatoid factor (RF) are almost always negative.

Distal interphalangeal predominantly RP (PID) primarily affects the distal interphalangeal joint. It is the joint closest to the tips of the fingers and toes.

In a person with a predominantly PID PsA, it is estimated that more than 50 percent of all impacted joints are DIP joints. This type of PsA can be symmetrical or asymmetrical and the impacts about 10 percent of people with PsA.

Symptoms

In addition to the other general symptoms of RP, nail changes are very common in people with PID-predominant RP. These can include nail pitting, nail cracks, and separation of the nail from the nail bed (onycholysis).

PsA spondylitis primarily affects the joints between your vertebrae. You may also see this type of PsA called axial arthritis. PsA spondylitis is thought to be present in 7 to 32 percent of people with PsA.

Symptoms

In addition to the other general symptoms of RP, people with RP spondylitis also experience pain, swelling, and stiffness in the neck and back, which can make movement very difficult.

Although PsA spondylitis primarily affects the spine, people with this type of PsA may experience symptoms in other joints as well. These may include:

PsA mutilans is the most severe type of PsA. It is rare and is estimated to affect around 5% of all people with PsA. The small joints of the hands, feet and wrists are most often affected.

Symptoms

In PsA mutilans, the inflammation is very severe, leading to significant damage to the affected joints. This can lead to symptoms such as:

• deformities of the affected joint, which can be serious
• problems with movement and range of motion
• bone loss in the affected joint, which can lead to shortening of the fingers or toes

PsA mutilants can impact other areas as well. People with this type of PsA may also experience neck and back pain.

Early diagnosis of PsA is vital. This is because starting treatment as early as possible can help prevent further joint damage.

A doctor will typically use the following steps to diagnose PA:

• Medical background: To get an idea of ​​your medical history, a doctor will ask you a variety of questions, which may include:
  • When did you first notice your symptoms?
  • How would you describe the severity of your symptoms?
  • Is there anything that improves or worsens your symptoms?
  • Do you have a family history of psoriasis or PsA?
  • What medications or supplements are you currently taking?
• Physical examination: Then your doctor will do a physical exam. During this time, they will examine your joints for any signs of tenderness and swelling. They will also check for movement difficulties or nail changes.
• Blood tests: Blood tests for PsA look for signs of inflammation and may include tests like those for C reactive protein (CRP) and rheumatoid factor (RF). A negative test for RF can help rule out RA.
• Imaging: Imaging technology can help your doctor assess your joints for signs of inflammation and damage. Examples of imaging techniques that can be used include X-rays and MRI.

There are several potential treatment options for PsA. What is involved in your specific treatment plan may depend on a variety of factors, including:

• the severity of your symptoms
• how many joints are impacted
• which joints are affected
• the extent of damage in the affected joints
• your responses to previous treatments for PsA
• your overall health
• your personal preference

Medicines

A variety of drugs can be used in the treatment of RP. Here are some examples :

• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs are drugs that can relieve inflammation and pain in mild RP. They are available over the counter or by prescription.
• Disease-modifying anti-rheumatic drugs (DMARDs): DMARDs are drugs that help prevent mild to moderate RP from getting worse. Examples of ARMs include methotrexate, sulfasalazine, and apremilast (Otezla).
• Organic Products : Biologics are a new type of DMARD. These are proteins that target specific parts of the inflammatory process. They can be used for more severe RP or spondylitis. Examples of biologics are adalimumab (Humira) and secukinumab (Cosentyx).
• Immunosuppressants: Immunosuppressants are drugs that slow down the activity of your immune system. Due to the availability of organic products, they are not used as often. Examples include cyclosporine and azathioprine.
• Corticosteroids: Corticosteroids work to reduce inflammation. They can be given as a pill or as an injection. Due to side effects, oral corticosteroids are taken at the lowest dose for the shortest time possible.

Surgery

Surgery can sometimes be used for PsA. But this type of treatment is usually only recommended when the PsA has severely damaged the joints.

Exercise

Regular, low-impact exercise like walking and swimming can also help keep joints healthy. Physiotherapy may also be recommended to improve or maintain strength, flexibility, and range of motion.

PsA is an autoimmune disease. This is where the immune system mistakenly attacks healthy tissue, leading to inflammation and damage.

The exact cause of the behavior of the immune system in people with RP is not clear. It is believed that a complex combination of genetic and environmental influences may play a role.

About 33 to 50 percent of people with RP have at least one close relative with psoriasis or RP. In addition, several genes associated with PsA have been identified.

Environmental factors that can contribute to the development of PsA include things like infections or physical trauma.

PsA is a disease that can affect some people with psoriasis. It can cause inflammation and joint pain ranging from mild to severe. Symptoms of RP can also impact movement and quality of life.

There are 5 different subtypes of PsA. These are broken down based on factors such as the area affected and the severity of symptoms. It is possible that a person with PsA may have symptoms that correspond to several subtypes of PsA.

A variety of treatments can help relieve the symptoms of RP and slow the progression of the disease. Early diagnosis is important to prevent further joint damage. See a doctor as soon as possible if you have symptoms of RP.