Psoriatic Arthritis SignsPsoriatic arthritis signs and symptoms most commonly appear when the joint pain and swelling begin, and the psoriatic skin lesions have been present for a while. The typical skin lesion is a scaly, red, itchy patch. Ninety percent of PsA patients also have characteristic pitting, ridges, and discoloration of the fingernails and toenails.
Joint pain, stiffness, and swelling can affect all major and all minor joints, including the spine, from the neck to the lower back and both sacroiliac joints. There are several common patterns of joint involvement. Unusually for an inflammatory arthritis, the most distal joints of the fingers (the DIP joints) are often involved. Psoriatic arthritis also can affect the attachment of the tendons (attaching muscle to bone) and the ligaments (attaching bone to bone) surrounding joints. This is known as enthesopathy. It commonly shows up in the foot as Achilles tendonitis (the back of the heel) or a plantar fasciitis (sore heel). The characteristic appearance of swollen fingers or toes, all the way down to the tips, with a sausage-like appearance and nail involvement is known as dactylitis.
Sometimes inflammatory eye conditions accompany the joint inflammation of psoriatic arthritis. As the skin lesions of psoriasis wax and wane, so does the joint involvement, although in an unpredictable pattern.
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