Psoriatic arthritis mostly affects the joints in your hands and feet, but you can have symptoms elsewhere in your body. You may notice swollen joints, skin rashes, structural changes, or even symptoms in your eyes.
Psoriatic arthritis (PsA) is a chronic form of arthritis. It can affect the small and large joints of your body. It can also affect your skin, nails, tendons, and gastrointestinal system.
You may experience PsA symptoms consistently. You may also have flare-ups. That’s when symptoms are worse for a bit and then get better or disappear.
The signs and symptoms of PsA are often visible. In addition to knowing how the condition makes you feel, noticing changes in how your body looks can help you manage your PsA.
PsA can change the shape and look of your fingers and nails.
PsA on your fingers
You may notice that your fingers look swollen or have a “sausage-like” appearance. This is from swelling of the middle joint. The medical term for this is “dactylitis.”
The end joint of your finger may also appear bent or crooked. This is from a structural change due to bone loss in your finger.
Known as a “pencil-in-cup” deformity, the end of the middle bone is narrow (like the tip of a pencil), and the base of the end bone is curved (like a cup).
PsA on your nails
Your nails may have small indentations or pits. They can also crumble and break off. The nails may separate from the nail bed.
PsA can cause your heels and toes to appear swollen or inflamed. It can also cause toenail changes.
PsA on your heel
You may have inflammation of the Achilles tendon, which connects your calf muscle to your heel. The lower part of your leg above the heel may look swollen, and you may feel pain.
PsA on your toes
You may experience dactylitis in your toes. As with dactylitis in the fingers, this causes the digit to have a sausage-like appearance.
Toenails may also separate from the nail bed, crumble, or have indentations or pits, in the same way that PsA affects fingernails.
Swollen joints are often an early symptom of PsA. In addition to the small joints of the hands and feet, PsA can cause swelling in large joints, such as the knee.
Photo by DermNet New Zealand
Many people with PsA have psoriatic skin lesions before other symptoms of PsA. These are often raised, scaly patches of skin that may be itchy. They can appear anywhere on the body.
Charnsitr/Getty Images
You may experience conjunctivitis, or pink eye, as a symptom of PsA.
You may also see signs of uveitis, which is inflammation in the middle of the eye. About
Uveitis can make your eyes look red. It may also make your pupils irregularly shaped or small.
Crespo-Rodríguez, A.M., Sanz Sanz, J., Freites, D. et al. Role of diagnostic imaging in psoriatic arthritis: how, when, and why. Insights Imaging 12, 121 (2021). https://doi.org/10.1186/s13244-021-01035-0 (CC BY 4.0)
Changes in the body from PsA may be visible on an X-ray. These typically involve changes to the joint, loss of bone, and inflammation.
Some signs that might be visible include:
- narrowing of spaces between joints
- erosion of the bone around the joint
- inflammation of the tissue around the bone (periostitis)
- bone spurs
- bone fusion (ankylosis)
- destruction of bone tissue (osteolysis)
Resources for support
If you or someone you care for has PsA, you may wish to reach out for support. The National Psoriasis Foundation and Arthritis Foundation can connect you with online and in-person support groups. They also have extensive information about PsA from people living with the condition.
If you have a family doctor, they may be able to identify what might be causing your symptoms and help you develop a personalized treatment plan.
If you would like mental health support, you can call the Substance Abuse and Mental Health Services Administration’s National Helpline at 800-662-HELP (4357), or dial 988 to reach the Suicide and Crisis Lifeline if you are experiencing a crisis.
