Question
I was diagnosed with “psoriatic arthritis” over a year ago. My problem began with inflammation of the knee, which was then followed by psoriasis. My knee was so badly inflamed that I had to get an operation to get the synovial lining removed after inflammatory tablets did not work having taken them for several months. It was so swollen and bent that I could not walk. Thankfully after the operation I got movement back. Since then I have been on a drug called salazopyrine. For the past two months I have been getting pains in my fingers, toes and especially in my elbow joints, no attack of psoriasis as yet, but the pain is getting worse. I was tested for rheumatoid but results were negative. I am just afraid of what’s going to happen next. Is it going to spread throughout my body and what does the future hold for me?
Answer
Psoriatic arthropathy is a form of arthritis that occurs in people who have psoriasis. Sometimes the arthritis can precede the development of the typical skin rash that we recognise as psoriasis. The joint condition can occur in approximately 10% of psoriasis sufferers. It is not possible for us to predict which sufferers of psoriasis will develop the arthritis. Both sexes are equally affected. The peak age of onset is between 20 to 30 years old but it can occur at any age. There are no specific diagnostic tests for psoriatic arthropathy. The negative test result for rheumatoid arthritis that you refer to was presumably done to out rule the presence of that particular form of arthritis. Psoriatic arthropathy tends to be a mild form of arthritis but you appear to have suffered a very active form of the condition. It is difficult to give a prognosis to you but in general terms the condition is subject to remission and relapse. Therefore you can expect that you might have intermittent flare-ups of the condition followed by periods of remission. The drug salazopyrine that you refer to in your question is prescribed to attempt to modify the course of the illness. If that drug is not successful for you there are more potent alternatives. Although we cannot cure the condition I would be confident that it should be possible to bring your condition under control.