A83_SameJoints Busted

Does inflammation always affect the same joints on both sides of the body for psoriatic arthritis?

Joint pain

Synopsis

No. There are different types of psoriatic arthritis (PsA), and the symmetry of inflammation can be observed or not, depending on the type of PsA. In any case, if you have pain in your joint and suffer from psoriasis, you should make sure to let your physician know about it, whether the same joints or different joints are affected.

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Expert Answers

Dr. Marc Bourcier:

The answer is no, but it does not mean that it never happens that inflammation can affect the same joints on both sides of the body. Simply put, the reality is more complex. There are five main classical patterns of arthritis seen in psoriatic arthritis (PsA).

The two most common types of PsA are asymmetric oligoarthritis, where usually four or less joints are affected and symmetry is not observed (67% of cases) and symmetric polyarthritis, for which the inflammation affects the same joints on both sides of the body (about 17% of cases).

The three other types of PsA are distal interphalangeal predominant psoriatic arthritis, that mostly affect fingers, toes and nails, spondylitis, that affects the spinal column, and arthritis mutilans, which is the most severe and, happily, the rarest form of PsA.

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Simmie Smith:

It is important to know that there are different types of psoriatic arthritis, and for this reason, the answer to the question is “no”. However, my experience over the years has certainly been that if one joint is affected it will only be a few days later that the same joint on the other side of my body is impacted. Being aware of this helps me do what I can do to prevent common triggers of my joint pain. As an example, if my wrists are sore, I will try my best to avoid stress on them. Sometimes you have no choice but to let your body rest. 

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Sandra Walsh:

Although a common form of psoriatic arthritis (PsA) affects the same joints on both sides of the body, many people have a form of PsA that does not necessarily affect the same joints on both sides. This type of PsA is called asymmetric oligoarthritis and affects less than five joints anywhere on the body. Your rheumatologist classifies your disease based on the number of joints affected, what joints are affected, and the degree of damage to the joints.

In our clinic, all healthcare practitioners look at the patient’s joints and ask about joint pain, swelling, and stiffness of the joints in the morning. It is very important to identify these symptoms early and get a referral to a rheumatologist as soon as possible. Patients who see the joint specialist early after developing their symptoms have less damage to their joints than those that have a delayed referral.

If you have psoriasis and have any joint pain or swelling, swollen hands, or trouble with moving or stiffness in the joints or back in the morning you need to report these symptoms to your healthcare practitioner and ask if a referral to the rheumatologist is right for you.

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Painful joints might hide something else

I want to know what it is