What should you know about psoriatic arthritis PSA symptoms?

Psoriatic arthritis commonly presents with painful or swollen joints and stiffness after rest or waking. It may involve one area or several, and symptoms can vary from side to side. A whole finger or toe may swell, rather than only one knuckle. Tendon attachment pain can occur at the heel or under the foot, while inflammation near the ribs may hurt with movement or deep breathing. Nail pitting, separation or colour change and psoriasis plaques can provide useful context, but some people develop joint symptoms before obvious skin disease. These symptoms do not prove the diagnosis; a clinician considers the examination and the overall pattern.

Note which joints are affected, how long stiffness lasts after waking, whether swelling is visible and whether symptoms improve with gentle movement. Photograph intermittent swelling if it has settled before an appointment. Avoid forcing a painful joint, but keep comfortable range-of-motion activity if it does not increase symptoms. Arrange assessment when symptoms recur or interfere with work, sleep or walking. Read about [Joint Pain](/symptoms/joint-pain/) and [Morning Joint Stiffness](/symptoms/morning-joint-stiffness/).

Arrange medical review for ongoing swelling, repeated morning stiffness, unexplained heel pain or a swollen whole finger or toe. Seek urgent help if a joint becomes suddenly hot and severely painful, especially with fever, or if chest pain comes with breathlessness, faintness or sweating. Those features need assessment for other urgent causes as well as inflammatory arthritis.

Could my symptoms represent inflammatory arthritis? Which joints or tendons should I monitor? Do my nails or skin change the assessment? What movement is appropriate while symptoms are active?