What Parts of the Body Are Affected by Psoriatic Arthritis?

Psoriatic arthritis (PsA) is more than a joint disease. PsA is an autoimmune disease. Autoimmune means it occurs when your immune system mistakenly attacks healthy tissue.

The faulty immune response causes inflammation that triggers joint pain, stiffness, and swelling. The inflammation can affect the entire body and may lead to permanent joint and tissue damage if it is not treated early and aggressively.1

Understanding psoriatic arthritis inflammation

PsA affects some people who have psoriasis. Psoriasis is also a chronic (long-term) autoimmune condition. Psoriasis causes skin symptoms, such as itchy, burning, thick, scaly patches. It is more common for psoriasis symptoms to occur first before PsA. Sometimes psoriasis can be present for up to 10 years before PsA appears.1,2

Inflammation from PsA can happen throughout the body. Because of this, different parts of the body can be affected.

Joints

In some people, PsA only affects a few joints. In others, PsA affects many joints in the body. The wide range in how the disease appears in different people is part of what makes diagnosis a challenge.1,2

Psoriatic arthritis can affect the joints on 1 side or both sides of the body.1,2

Hands and feet

Psoriatic arthritis may affect your hands and feet. Painful swelling, known as dactylitis, may sometimes be called “sausage” fingers or toes because of the swollen appearance. This condition can be debilitating and cause severe impacts on your daily life and function. About 40 percent of those with PsA experience dactylitis.3,4

Enthesitis is a painful swelling of the entheses, the connective tissue that joins tendons and ligaments to the bone. Enthesitis may occur in PsA and affect your hands and feet. The most common places this can happen include:3,4

  • The bottoms of the feet
  • The Achilles’ tendons
  • Ribs
  • Spine
  • Pelvis

This type of swelling is unique to PsA and occurs in about half of all people with PsA.3,4 PsA may also cause your nails to be cracked, pitted, crumbly, or thickened. This is known as nail psoriasis.5

Knees

One or both knees may be affected by PsA. Joint inflammation and inflammation of where the tendons and ligaments meet the bone are common in PsA. Symptoms of PsA in the knee include:5

  • Stiffness, especially first thing in the morning or after a period of rest
  • Painful joints
  • Swelling
  • Reduced range of motion

Spine and hips

When PsA affects the spine, it is often referred to as one of the following:4,6

Psoriatic spondylitis, which refers to inflammation in the joints between the vertebrae
Sacroiliitis, which refers to inflammation in the joints between the spine and the pelvis. It can be asymmetrical (occurring only on 1 side of the body).

Eyes

Eye inflammation, known as uveitis, affects about 7 percent of people with PsA. It is a serious complication of psoriatic arthritis. Symptoms of uveitis include:2

  • Redness
  • Irritation
  • Blurred vision

Although not common, uveitis may lead to permanent loss of vision if untreated. Conjunctivitis, also known as “pink eye,” is an infection of the eye’s clear membrane. You may have thick yellow, white, or greenish discharge from the eye in addition to the eye being red and painful. Conjunctivitis occurs more frequently with PsA.2

Sjogren’s syndrome, an autoimmune disease that causes dry eyes and mouth, may also occur in PsA.2

Heart

Studies have shown that PsA increases the risk of developing heart disease by 40 to 50 percent. This is because long-term inflammation damages blood vessels and can lead to stroke or heart attack. Managing your weight, blood pressure, cholesterol, and activity levels may decrease your risk.2

Liver

People with psoriatic disease are at increased risk for developing nonalcoholic fatty liver disease. This occurs when fat cells build up in your liver.2

Bowels

Studies have shown that people with PsA have a greater risk of developing inflammatory bowel disease (IBD), including Crohn’s disease. Many treatments used to treat PsA also treat IBD.2

Kidneys

Kidney disease may occur with PsA, though it is more common in moderate to severe psoriasis.2

Ears

Some studies have shown that certain cases of hearing loss may be caused by inflammation and the body attacking healthy cells. Psoriatic arthritis may cause hearing problems. Talk to your doctor about monitoring your hearing.2

Mental health

PsA can negatively affect your mental health. Chronic pain and body image issues can lead to sleep disorders, fatigue, long-term stress, and depression or mood changes.

You may have to take time off of work sometimes, which leads to decreased productivity. Talk to your doctor about your mental health. This is just as important as your physical health.7

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Emily Downward and Katie Murphy | Last reviewed: December 2020.