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Psoriatic Arthritis: Causes, Symptoms, Diagnosis, Treatment, and Prevention

Psoriatic arthritis is a type of inflammatory arthritis that affects some people with psoriasis, a chronic skin condition that causes red, scaly patches. As well as causing joint pain, stiffness, swelling, and damage, psoriatic arthritis can affect the skin and nails. Despite the fact that psoriatic arthritis can affect any joint in the body, it is most common in the fingers, toes, wrists, ankles, knees, and lower back. Eyes, tendons, ligaments, and the spine can also be affected by psoriatic arthritis.

Causes of Psoriatic Arthritis

As far as the cause of psoriatic arthritis is known, it is believed to be caused by a combination of genetic and environmental factors. An autoimmune disease, psoriatic arthritis is caused by the immune system mistakenly attacking healthy cells and tissues in the body. The following factors may trigger or worsen psoriatic arthritis:

• Having psoriasis, especially if it is severe or involves the nails

• Having a family history of psoriasis or psoriatic arthritis

• Having certain genes that are associated with psoriatic arthritis

• Having a history of physical trauma or infection that may activate the immune system

• Being overweight or obese, which can put extra stress on the joints

• Smoking, drinking alcohol, or having a poor diet, which can affect the immune system and inflammation

Symptoms of Psoriatic Arthritis

The symptoms of psoriatic arthritis can vary from person to person, and they may change over time. Some of the common symptoms of psoriatic arthritis include:

• Painful, swollen, and stiff joints, especially in the morning or after rest

• Reduced range of motion and function in the affected joints

• Red, scaly, and itchy skin patches, usually on the elbows, knees, scalp, and lower back

• Nail changes, such as pitting, thickening, lifting, or crumbling of the nails

• Fatigue, low energy, and poor sleep quality

• Eye problems, such as redness, pain, dryness, or blurred vision

• Tendon or ligament problems, such as inflammation of the Achilles tendon or the plantar fascia

• Enthesitis, which is inflammation of the places where tendons or ligaments attach to the bones, such as the heel, elbow, or ribs

• Dactylitis, which is swelling of the entire finger or toe, giving it a sausage-like appearance

Diagnosis of Psoriatic Arthritis

There is no specific test that can diagnose psoriatic arthritis, but a doctor can use a combination of methods to rule out other conditions and confirm the diagnosis. Some of the methods that a doctor may use include:

• Medical history and physical examination, to check for signs and symptoms of psoriatic arthritis, such as joint swelling, skin lesions, and nail changes

• Blood tests, to measure the levels of inflammation, antibodies, and other markers that may indicate psoriatic arthritis or other types of arthritis, such as rheumatoid arthritis or gout

• Joint fluid analysis, to collect and examine a sample of fluid from an affected joint, to look for signs of infection or crystals that may cause gout

• X-rays, to look for changes in the bones and joints, such as erosion, narrowing, or fusion

• MRI, to obtain detailed images of the soft tissues, such as the tendons, ligaments, and cartilage, and to detect early signs of joint damage

• Ultrasound, to visualize the inflammation and blood flow in the joints and tendons

Treatment of Psoriatic Arthritis

There is no cure for psoriatic arthritis, but treatment can help control the symptoms, prevent joint damage, and improve the quality of life. Treatment options for psoriatic arthritis include:

• Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), biologic drugs, corticosteroids, and pain relievers, to reduce inflammation, pain, and swelling, and to slow down the progression of the disease

• Physical therapy, to improve the strength, flexibility, and function of the affected joints, and to prevent stiffness and deformity

• Occupational therapy, to help with daily activities, such as dressing, bathing, and working, and to provide adaptive devices, such as splints, braces, or shoe inserts, to protect and support the joints

• Surgery, to repair or replace severely damaged joints, such as the hip, knee, or elbow, or to correct deformities, such as clawed toes or hammer fingers

• Alternative therapies, such as acupuncture, massage, yoga, or tai chi, to relieve stress, pain, and inflammation, and to promote relaxation and well-being

Prevention of Psoriatic Arthritis

There is no way to prevent psoriatic arthritis, but there are some steps that can help reduce the risk of developing or worsening the condition, such as:

• Treating psoriasis promptly and effectively, to prevent or delay the onset of psoriatic arthritis

• Maintaining a healthy weight, to reduce the pressure and stress on the joints

• Eating a balanced diet, rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, to provide the nutrients and antioxidants that can support the immune system and fight inflammation

• Avoiding or limiting alcohol, tobacco, and caffeine, which can trigger or aggravate psoriasis and psoriatic arthritis

• Exercising regularly, to improve the blood circulation, muscle strength, joint mobility, and mood, and to prevent stiffness and pain

• Protecting the skin and joints from injury, infection, or irritation, by wearing sunscreen, moisturizing the skin, avoiding harsh chemicals, and using gloves or pads when needed

• Getting enough sleep, to allow the body to rest and heal, and to prevent fatigue and depression

• Seeing a doctor regularly, to monitor the condition, adjust the treatment, and prevent complications