Psoriatic Arthritis
Psoriatic arthritis often hides in plain sight. Patients tell me about a painful finger, a stiff back or a swollen ankle, and only later mention psoriasis on the scalp or a childhood family history. It matters to me that we recognise psoriatic arthritis early, because the right treatment protects your joints, your tendons and your quality of life.
What psoriatic arthritis is
Psoriatic arthritis is an inflammatory arthritis that can affect people with psoriasis, sometimes before the skin ever flares. It can involve individual joints such as fingers or knees, the small joints closest to the nails, the tendons and their attachments (enthesitis), the whole finger or toe as a sausage-like swelling (dactylitis), the nails, and the spine.
Symptoms to look out for
Painful, swollen finger, toe, knee or ankle joints
A whole finger or toe that swells up like a sausage
Pain and stiffness at the back of the heel or under the foot
Lower back or buttock pain that is worse with rest and better with movement
Morning stiffness lasting more than 30 minutes
Nail changes such as pitting, ridging or lifting from the nail bed
A personal or family history of psoriasis, even mild
Why this matters to a rheumatologist
As a rheumatologist, I look at psoriatic arthritis as more than a joint condition. I assess the joints, tendons, spine, skin and nails, because psoriatic arthritis can move between these areas. Early diagnosis matters because joint damage can happen quietly. Modern treatment is very effective, and I want to reach it before damage sets in.
Signs I would like you to seek care for
For emergency symptoms please seek urgent or emergency care first rather than waiting for a WhatsApp reply.
A swollen, hot, red joint, which may need urgent review
New joint swelling that is not settling after a week or two
A whole finger or toe that swells like a sausage
Persistent heel or foot pain, especially in both feet
Back pain that wakes you at night or stiffens you in the morning
Eye redness, pain or blurred vision (possible uveitis) which needs urgent eye review
What a specialist review looks like
In clinic I take a careful history, examine your joints, tendons, nails and skin, and order blood tests and imaging where helpful. If I confirm psoriatic arthritis, I explain the diagnosis in plain language and discuss treatment options ranging from NSAIDs and steroid injections through to disease modifying medications such as methotrexate, and modern biologic and targeted therapies. Treatment is chosen based on which parts of you are involved.
Questions my patients often ask me
Speak with me
If you have psoriasis with joint, tendon, back or nail symptoms, or unexplained finger or toe swelling, please seek specialist care. I would like to help you catch psoriatic arthritis early and treat it well.
Other conditions I treat
This page is for general education only and does not replace medical advice. Please consult a qualified healthcare professional for diagnosis and treatment.