Psoriatic arthritis (PsA) is a chronic inflammatory disease of the joints that is usually associated with the autoimmune skin condition, psoriasis. In 85% of people with PsA, the skin disease will be present before they develop symptoms of joint disease. Overall, about 30% of people with psoriasis will end up developing psoriatic arthritis.

Like other types of arthritis, people with PsA experience swelling, pain, and tenderness of their joints. Because of this, PsA may sometimes be confused with other types of arthritis such as rheumatoid arthritis, gout, and reactive arthritis. One of the ways it is different from these other types of inflammatory arthritis is in the pattern and distribution of the joint pain as well as the presence of pitted fingernails and a personal or family history of psoriasis or arthritis.

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More than 1 million people in the U.S. live with psoriatic arthritis. It affects men and women equally, and symptoms usually appear between the ages of 30 and 50. There is no definitive test for PsA, however, your healthcare provider, or a rheumatologist, may perform a physical exam to assess joint swelling and inflammation, nail abnormalities, and other factors. The history and physical will help distinguish between an inflammatory arthritis and a degenerative arthritis such as osteoarthritis.


Healthy on the outside

PsA is a chronic inflammatory disease that can be painful and sometimes debilitating. Often, patients appear to be healthy “on the outside” but their condition is actually impacting their mobility in daily life. At the most basic level, some are unable to walk easily or climb stairs. Because others can’t “see the symptoms,” they don’t understand the impact or acknowledge the importance of the condition. PsA can be associated with obesity and an increased risk of heart disease.

While there is no cure, psoriatic arthritis can be managed. Early recognition, diagnosis, and treatment are critical to relieve the pain and inflammation of PsA. A 2014 study titled, “Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis,” found that a delay in diagnosis of 6 months or more is associated with significantly more joint and bone damage and worse physical disability compared to those with early diagnosis. Unfortunately, delayed diagnosis is all too common. The same study showed that only 30% of people had their PsA diagnosed within 6 months while up to 70% had a delay in diagnosis of up to two years. The lead author of the study, Dr. Muhammad Haroon concluded that,

“…patient education is key to making sure that people with psoriatic arthritis are diagnosed and treated as soon as possible.”

That is why I teamed up with The Doctor Weighs In to help readers understand the condition.


What you need to know

It is important for people to know the factors associated with PsA, talk with their healthcare provider to obtain the right diagnosis, and determine a treatment plan that works for them. If you have PsA or think you may be experiencing PsA symptoms, but aren’t sure of how to start that conversation with your healthcare provider, you can find doctor discussion guides and other resources to help you at

While you can receive a diagnosis from any healthcare provider, a rheumatologist specializes in rheumatic diseases, such as PsA, and would work with you for long-term care of your symptoms. If you think you may be experiencing PsA symptoms, talk to your healthcare provider or a rheumatologist who can provide a diagnosis and help determine a treatment plan that works for you.

As PsA can affect a person’s mobility, the ability to exercise and to what extent varies from person to person. I urge all patients to work with their healthcare providers to figure out an exercise plan that works for them because maintaining muscle strength is an important tool to maintaining function now and in the future.

With education comes investment in research, and I look forward to seeing what the future brings. There are many studies and research being done in the world of autoimmune disorders, which you can find online or ask a healthcare provider or rheumatologist for specifics. For more information about ways to talk to your healthcare provider about your symptoms and manage your disease, visit

Madelaine H. Feldman, MD, FACR
Madelaine Hedgpeth Feldman, MD, FACR, is a rheumatologist in private practice with The Rheumatology Group in New Orleans, Louisiana. She completed medical school, an Internal Medicine residency and a Rheumatology fellowship, at Tulane University Medical School. She is a founding member and past President of the Rheumatology Alliance of Louisiana, Vice-president of the Coalition of State Rheumatology Organizations, (CSRO) and presently serves on the insurance subcommittee for the ACR. She is a member of the Biologic working group of the Alliance for Patient Access and serves as a medical editor for Health Monitor Network. Dr. Feldman, a Clinical Associate Professor of Medicine at Tulane University School of Medicine, has been named one of the Top Doctors in New Orleans for over 10 years, and also had a medical radio talk show, “Driving with Dr. Mattie,” which aired locally during drive time.


  1. My neighbor has Psoriatic arthritis. I like that you explain that Psoriatic arthritis is an inflammatory disease that affects persons with psoriasis. Thank you for the information. I’ll provide this information to my neighbor so he can get psoriatic arthritis treatment.


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