First Signs

Dr. Irwin Lim
Rheumatologist

It’s difficult to tell you how psoriatic arthritis typically presents because it’s a disease which can present in so many ways. It can present with joint pain or joint tenderness, sometimes joint swelling. It can present in the small joints of the hands and feet, or in a large joint such as the knee. It can present with spinal pain or it can present with a difficult-to-treat tendon problem. For example, the tennis elbow, or an Achilles tendon problem, or the patella tendonitis.

Dr. Samuel Whittle
Rheumatologist

Often the first thing people will notice is that sense of stiffness on waking up in the morning. But sometimes they will notice some swelling of the joints, particularly if it’s the larger joints like the knees or ankles.

Linda Bradbury
Nurse Practitioner, Rheumatology

Psoriatic arthritis you can get problems with the back but it’s less common; about 20% of people, so 20 in 100 people will get some back issues but very commonly the joints that are affected in psoriatic arthritis again tend to be the big joints like knees but also patients will tend to get problems with their fingers so big sausage-like digits are very common in psoriatic arthritis. Sometimes patients will have psoriasis before they get arthritis and other times, less commonly, you get the arthritis then the psoriasis. You can also have psoriatic arthritis without having psoriasis at all but there can be quite a strong family history of psoriasis and so the doctors when you go and see them will ask you very closely about your history.

Ray Paulley
(Psoriatic Arthritis)

He said, “Well, do you ever get any flaking or itchy on your elbows, your head, or anywhere on your body?” I said, “As a matter of fact, I do.” But I’ve got cousins that really get it bad and I’d never thought of it much because it was just like a mild flaking, didn’t’ really bother me.

Dr. Marina Kang
General Practitioner

Psoriatic arthritis may sometimes be a bit masked because we are focussing on the psoriasis itself perhaps so we need to be able to get patients to come in early with any joint signs, stiffness, pain, swelling. And any family history of psoriasis in a patient’s profile needs to be sought out so a patient needs to come and let us know if there is any family history, what their skin condition is like, and we need to know about what’s been affecting or concerning them with their joints and their skin. Any joint tenderness, any stiffness and pain with their joints in someone who has a background history or family background history of psoriasis that would make us be more aware that perhaps we need to be looking for psoriatic arthritis in these patients.