Psoriatic arthritis (PsA) is a type of arthritis that often occurs along with the skin condition psoriasis. One common type is asymmetric oligoarticular PsA.
Psoriatic arthritis (PsA) is a type of inflammatory arthritis that usually occurs alongside the skin condition psoriasis. Experts estimate that
There are several types of PsA. One of the most common types is asymmetric oligoarticular PsA, which affects only a few joints on one side of your body.
Keep reading for more information about asymmetric oligoarticular PsA, including its causes, its symptoms, and how doctors diagnose and treat it.
Definitions
Here are some definitions to help you understand asymmetric oligoarticular PsA:
- Asymmetric: An asymmetric condition affects the two sides of your body differently.
- Oligo: “Oligo” means a few or a little of something.
- Articular: “Articular” means something is related to your joints.
Generally, there are five types of PsA:
- Asymmetric oligoarticular PsA: Asymmetric oligoarticular PsA involves only a few joints on one side of your body. It affects about
60%Trusted Source of people with PsA. - Symmetric polyarthritis: Symmetric polyarthritis affects more joints than asymmetric oligoarticular PsA. It also affects joints on both sides of your body.
Between 15% and 61%Trusted Source of people with PsA have this type. - Distal interphalangeal PsA: Distal interphalangeal PsA mainly affects the ends of your fingers and toes. Nail changes are particularly common in this type of PsA. In occurs in
about 10%Trusted Source of people with PsA. - Psoriatic spondylitis: Psoriatic spondylitis affects the joints between your vertebrae. It can cause back and neck pain as well as difficulty with movement. Experts think it affects
between 7% and 32%Trusted Source of people with PsA. - Arthritis mutilans: Arthritis mutilans is the most severe type of PsA. It causes severe inflammation and can lead to structural changes in joints, particularly in your hands and feet. This condition affects fewer than 5% of people with PsA.
It’s possible to have more than one type of PsA at the same time. For example, you might have asymmetric oligoarticular PsA that occurs along with psoriatic spondylitis.
Asymmetric vs. symmetric PsA
Let’s take a moment to summarize what we know about asymmetric versus symmetric PsA:
- Asymmetric PsA affects only one side of your body, while symmetric PsA affects both sides of your body.
- In asymmetric PsA, only a few joints are affected. More joints are involved in symmetric PsA.
- Asymmetric PsA can affect both small and large joints. Symmetric PsA typically involves smaller joints, such as those in your hands and feet.
- Symmetric PsA can be more severe than asymmetric PsA. A 2021 study found that people with polyarthritis were more likely to experience dactylitis and enthesitis than people with oligoarticular PsA.
Many people start out with asymmetric PsA and
This progression, along with the sometimes inconsistent definitions of the PsA types,
Like psoriasis, PsA is an autoimmune disease, which means that it occurs when your immune system mistakenly attacks healthy tissues. This autoimmune reaction can lead to increased inflammation, pain, and tissue damage.
At this point in time, the exact cause of PsA is unclear.
Genetics very likely plays a role. Researchers have identified variations in certain genes associated with PsA. Further, an estimated
Environmental factors such as infections, physical injuries, and high stress may also be important. These factors may help trigger the onset of PsA in people who are genetically predisposed to the condition.
The hallmark of asymmetric oligoarticular PsA is that it affects a small number of joints, typically
This type of PsA can cause symptoms such as:
- joint swelling
- tenderness or pain in the affected joints
- joints that feel warm to the touch
- reduced range of motion in the affected joints
- joint stiffness, especially in the morning
- fatigue
- nail changes such as cracking and pitting
- dactylitis (swelling of an entire finger or toe)
- enthesitis (pain and swelling in places where ligaments and tendons connect to bone)
Because PsA is associated with psoriasis, you might also experience skin symptoms. Psoriasis is typically characterized by inflamed, scaly, itchy patches of skin that bleed when scratched.
PsA can be tricky to diagnose because it can be very similar to other conditions that affect your joints. For example, a doctor might misdiagnose asymmetric oligoarticular PsA as osteoarthritis, gout, or reactive arthritis.
A thorough physical exam, a medical history, and careful testing can help rule out other conditions.
During a physical exam, a doctor will take a look at your affected joints. When taking your medical history, they may ask you questions such as:
- How many of your joints are affected, and where are they?
- What types of symptoms do you have, and when did they start?
- How severe are your symptoms, and does anything make them better or worse?
- Has a doctor given you a diagnosis of psoriasis or another underlying medical condition?
- Does psoriasis or another medical condition run in your family?
To help determine the cause of your symptoms, a doctor will order further tests. Imaging tests such as X-rays can help them look at your joints. Blood tests can detect signs of inflammation and help doctors rule out other conditions.
Generally, you can treat PsA with a combination of medical treatments and at-home care. Overall, the goals of PsA treatment are to:
- reduce your symptoms
- prevent flare-ups
- slow or stop disease progression
- improve or maintain the range of motion of your joints
- improve your quality of life
Medical treatment
Doctors use several types of medication to treat PsA. The type they might recommend for you can depend on factors such as the severity and extent of your symptoms and which medications, if any, you have tried before.
They may recommend any of the following types of medications:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs are available over the counter. Examples include ibuprofen (Advil and Motrin) and naproxen (Aleve). They may help if your PsA symptoms are mild.
- Corticosteroids: Corticosteroids can reduce inflammation. You can take them either by mouth or as an injection into the affected joint. Doctors try to use them sparingly because of their potential side effects.
- Disease-modifying antirheumatic drugs (DMARDs): DMARDs also work to reduce inflammation and can help slow the progression of PsA. There are two types of DMARDs:
- Traditional DMARDs, such as methotrexate and sulfasalazine, broadly reduce the activity of your immune system.
- Biologics, such as adalimumab (Humira) and infliximab (Remicade), work by targeting the specific inflammation pathways associated with PsA.
Surgery is uncommon in PsA. However, a doctor may recommend it if the effects of PsA have led to severe joint damage.
After giving you a diagnosis of PsA, a doctor might recommend physical therapy. A physical therapist can teach you exercises to help improve or maintain your strength, flexibility, and range of motion.
If PsA has affected your ability to do daily activities, occupational therapy may also be helpful. An occupational therapist works with you to develop strategies for how best to perform daily activities at home, work, or school. They may also recommend adaptive equipment that can help with these activities.
If they are applicable to your situation, the following habits can also help you manage PsA:
- Get physical activity as directed by a doctor or physical therapist.
- Protect your joints by keeping up good posture and using assistive devices as needed.
- Apply hot and cold therapy to help with joint stiffness and swelling, respectively.
- Find healthy ways to lower your stress levels.
- Manage your weight as needed.
- Eat a balanced diet that emphasizes anti-inflammatory foods.
- Reduce or avoid consumption of alcohol.
- Quit smoking.
When left untreated, PsA can cause significant discomfort and affect your daily activities and quality of life. In severe cases, PsA may lead to structural changes in the affected joints.
You can manage PsA and slow its progression through a combination of medications and at-home care. Surgery for the condition is rarely necessary.
It’s also possible that asymmetric oligoarticular PsA will progress over time into symmetric polyarticular PsA, which affects more joints and can have more severe symptoms.
It’s important to have regular checkups with a doctor if you have any type of PsA. They can perform tests to help monitor your condition and catch any signs of progression early.
Asymmetric oligoarticular PsA is one of the five types of PsA. It’s one of the most common types of PsA and affects a small number of joints on one side of your body.
You can typically treat PsA with a combination of medications and at-home care. Together, these treatments can help relieve symptoms, slow the progression of the disease, and improve your quality of life.
As time passes, asymmetric oligoarticular PsA can progress to symmetric polyarticular PsA, which affects more joints on both sides of your body. For this reason, if you have PsA, it’s important to have regular checkups to monitor your condition.
