Psoriatic Arthritis is similar to rheumatoid arthritis but occurs in the presence of the skin condition psoriasis. Approximately 30% of psoriasis sufferers are affected, but there is no correlation with the severity of skin symptoms and the likelihood of arthritis.
Redness, swelling and pain of the end joints of the fingers or toes is the most common symptom, and typically starts between the ages of 20-50 years. Finger nails are pitted in most patients. Lower back pain is also relatively common. Symptoms usually flare and remit periodically.
Treatment is similar to that for rheumatoid arthritis. Manual therapy is not widely used.
Systemic Lupus Erythematosus (SLE)
SLE, or Lupus, is another body-wide condition. Again, the origin is unclear but is thought to be autoimmune in nature.
Presentation is very similar to rheumatoid arthritis, with the small joints of the hands and wrists being affected on both sides at once. Other symptoms are common, with a facial rash being the most definitive. Fever and fatigue also occur, as does generalised muscular aching.
Anti-inflammatories, immunosuppressants and Methotrexate are common medications used in treatment. Manual therapy tends not to provide much relief from Lupus symptoms.
Reactive Arthritis (Reiter's Syndrome)
Reactive Arthritis occurs following infection (usually chlamydia) and causes joint swelling and pain, pain on passing water, and conjunctivitis. This is more common in men.
Pain on urination (urethritis) is usually the first presenting symptom, followed by conjunctivitis and then joint symptoms. Blisters in the skin and mouth are common.
Joint pain affects the ankles and heels most frequently, and less commonly the knee or lower back. This can last for several years. There is currently no treatment apart from pain relief.