Psoriatic Arthritis -- Symptoms
Does psoriatic arthritis cause inflammation of organs?
Yes. Psoriatic arthritis can cause inflammation in other organs, such as the eyes. Inflammation in the colored portion of the eye (iris) causes iritis, a painful condition that can be aggravated by bright light.
Corticosteroids injected directly into the eyes of patients with iritis are sometimes necessary to decrease inflammation and prevent blindness. Rarely, inflammation in and around the lungs (pleuritis) causes chest pain, especially with deep breathing, as well as shortness of breath (also rare). Inflammation of the aorta (aortitis) can cause leakage of the aortic valves, leading to heart failure and shortness of breath.
Nail changes are commonly seen in psoriatic arthritis. Pitting and ridges are seen in the fingernails and toenails of 80% of patients with psoriatic arthritis. These characteristic nail changes are observed in only a minority of psoriasis patients who do not have arthritis.
When should I call my doctor about psoriatic arthritis?
If you have psoriasis and are experiencing joint pain, you should talk to your doctor. You should also contact your doctor if you have these symptoms:
- Stiffness in the joints
- Pain or swelling in the joints
- Irritation and redness of the eye
In order to identify psoriatic arthritis, your doctor will perform a physical exam. Your doctor may also order blood tests, joint fluid tests, and X-rays to examine the affected areas and rule out other diseases. Of course, the usual symptoms of psoriasis, such as red, scaly patches of skin, may make diagnosis of psoriatic arthritis easier for your doctor.
Psoriatic arthritis is a diagnosis made mainly with a physical exam, based on a finding of psoriasis and the typical inflammatory arthritis of the spine and/or other joints. With psoriatic arthritis, blood tests such as the sedimentation rate may be elevated and merely reflect the presence of inflammation in the joints and other organs of the body. Other blood tests such as rheumatoid factor are obtained to exclude the diagnosis of rheumatoid arthritis.
When large joints (such as knees) are inflamed, arthrocentesis can be performed. Arthrocentesis is a procedure whereby a sterile needle is used to withdraw (aspirate) fluid from the inflamed joints. The fluid is then analyzed for infection, gout crystals, and other inflammatory conditions. During the procedure, steroids can be injected into the joint to relieve pain and swelling.
X-rays may show changes of cartilage or bone injury indicative of arthritis of the spine, sacroiliac joints, and/or joints of the hands. Typical X-ray findings include bony erosions resulting from arthritis. The blood test for the genetic marker HLA-B27, mentioned above, can be found in more than 50% of patients with psoriatic arthritis who have spine inflammation.