Diagnosing Psoriatic Arthritis

Psoriatic arthritis can develop slowly with mild symptoms, or it can develop quickly and be severe. Early recognition, diagnosis and treatment of psoriatic arthritis can help prevent or limit extensive joint damage that occurs in later stages of the disease.

Generally, one or more of the following symptoms appears:

  • Generalized fatigue
  • Tenderness, pain and swelling over tendons
  • Swollen fingers and toes
  • Stiffness, pain, throbbing, swelling and tenderness in one or more joints
  • A reduced range of motion
  • Morning stiffness and tiredness
  • Nail changes—for example, the nail separates from the nail bed and/or becomes pitted and mimics fungus infections
  • Redness and pain of the eye, such as conjunctivitis

The disease can develop in a joint after an injury and may mimic a cartilage tear. The diagnosis of psoriatic arthritis may sometimes be made only after repeated episodes. Muscle or joint pain can occur without joint inflammation (swelling). Tendonitis and bursitis may be prominent features. Swelling of the fingers and toes can suggest a "sausage-like" appearance, known as dactylitis. Psoriatic arthritis usually affects the distal joints (those closest to the nail) in fingers or toes. The lower back, wrists, knees or ankles also may be affected.

In 85 percent of patients, skin disease precedes joint disease. Therefore, it is important to tell your dermatologist if you have any aches and pains. It is important to note that having a severe case of psoriasis does not necessarily mean a person will have a severe case of psoriatic arthritis. A person could have few skin lesions, but have many joints affected by the arthritis.

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