Types of Psoriatic Arthritis
Different Clinical Presentations of Psoriasis Joint Disease
Jan 5, 2009
There are five types of psoriatic arthritis: symmetric, asymmetric, distal interphalangeal predominant (DIP), spondylitis and arthritis mutilans.
Asymmetric Psoriatic Arthritis
Most common form of psoriatic arthritis. Affects about 35 percent of those with psoriatic arthritis and usually involves only one to three joints, such as the knee, ankle, wrist or finger, but usually does not occur on the same joint on the opposite side of the body. Affected hands and feet have enlarged “sausage” shaped digits, caused by swelling and inflammation of tendons near the joints. The involved joints are swollen, warm, tender and red.
Symmetric Psoriatic Arthritis
Less common than the preceding type. Usually affects multiple symmetric pairs of joints (occurring in the same joints on both sides of the body). There is sausage shaped swelling of one or more finger or toe joints
Distal Interphalangeal Predominant (DIP) Psoriatic Arthritis
Occurs in only about five percent of people with psoriatic arthritis. It primarily involves joints near the nails in the fingers and toes.
Spondylitis
Involves inflammation of the spinal column. The common symptoms are inflammation with stiffness of the neck, lower back, or spinal vertebrae, making movements and bending painful and difficult.
Arthritis Mutilans
This is a severe, deforming form of psoriasis arthritis that affects fewer than 5 percent of people with psoriatic arthritis. It predominantly affects the small joints of the hands and feet, though it can be associated with neck or lower back pain.
Pediatric Form of Psoriatic Arthritis
A pediatric form of psoriatic arthritis may appear as early as age 2 to 4 years in girls. A peak period of pediatric onset is age 11 to 12 in both girls and boys. In children the arthritis may appear several years prior to the onset of psoriatic skin lesions; this may pose a problem in recognizing the nature of the underlying disease, especially if there is no known family history of psoriasis.
Other joints like tempero-mandibular (jaw) joint, sternal joint etc also may be affected in psoriatic arthritis.
Although psoriatic arthritis and psoriasis occasionally occur in the absence of a history of psoriasis in the family, a genetic predisposition for psoriasis is considered to be a necessary condition for development of psoriatic arthritis. The evidence for inheritability is well established in psoriatic arthritis.
Nail Involvement occurs in about 75% of psoriasis patients with arthritis, but only in 25-30% in those with skin lesions alone.
Impact of Psoriatic Arthritis on Life Style
Psoriatic arthritis affecting the fingers can make performing simple daily activities difficult. Involvement of the spine has a severe debilitating effect on the patient that movements and work and quality of life is severely compromised.
Next: Psoriatic Arthritis: Diagnosis and Treatment
