Psoriatic arthritis and rheumatoid arthritis (RA) are both types of inflammatory arthritis that cause chronic swelling, stiffness, and joint pain. While they share similarities, they also have clear differences in symptoms, body areas affected, and diagnostic methods.

Symptoms Of Psoriatic Arthritis Vs. Rheumatoid Arthritis

Both conditions involve inflamed joints, but they differ in how they present:

  • Psoriatic arthritis: Often affects joints asymmetrically (one side of the body). It may also involve skin and nail changes.

  • Rheumatoid arthritis: Usually affects joints symmetrically (both sides at once). It commonly includes systemic symptoms like fever or lung issues.

Comparison of symptoms:

  • Swelling and pain: Both conditions

  • Joint stiffness: Worse in the mornings for both

  • Affected side: Psoriatic arthritis is asymmetrical, RA is symmetrical

  • Fatigue: Present in both

  • Sausage digits (swollen fingers/toes): Common in psoriatic arthritis, not in RA

  • Nail symptoms: Pitting, crumbling, or splitting in psoriatic arthritis; none in RA

  • Skin symptoms: Psoriasis plaques in psoriatic arthritis; nodules, redness, and warmth in RA

  • Other symptoms: Eye inflammation and digestive issues in psoriatic arthritis; fever, appetite loss, lung symptoms in RA

  • Symptom pattern: Both flare up and remit over time

Differences Between Psoriatic And Rheumatoid Arthritis

ra and psoriatic arthritis may affect different parts of the body

  • Psoriatic arthritis: Involves entheses (where tendons and ligaments attach to bone). Commonly affects the back, hips, neck, and feet, in addition to hands.

  • Rheumatoid arthritis: Involves the synovium (lining of the joints). Commonly affects wrists, hands, elbows, knees, shoulders, feet, spine, and jaw.

psoriatic and rheumatoid arthritis can affect different people

  • Rheumatoid arthritis: Two to three times more common in women and people assigned female at birth. Most often occurs between ages 65–80. Risks include smoking, gum disease, and lung conditions.

  • Psoriatic arthritis: Affects men and women equally, typically starting in the 30s or 40s. Risk increases with psoriasis and excess body weight.

psoriatic arthritis won't show up on lab tests

Blood tests can detect rheumatoid arthritis but not psoriatic arthritis. Psoriatic arthritis diagnosis depends on clinical symptoms and history, especially when psoriasis is present.

Similarities Between The Two Conditions

both involve your immune system

  • Psoriatic arthritis: Triggered by a mix of genes and environment, leading to joint and skin inflammation.

  • Rheumatoid arthritis: An autoimmune condition where the immune system attacks joint tissue.

your genes influence both

A family history of psoriasis raises psoriatic arthritis risk, while inherited immune-related genes can increase rheumatoid arthritis risk.

treatments for both overlap

Healthcare providers often use similar treatments for both conditions:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): For pain and swelling relief.

  • Corticosteroids: Injections to reduce inflammation.

  • DMARDs (disease-modifying antirheumatic drugs): Slows progression by targeting the immune system.

  • Biologics: Blocks specific immune cells to reduce symptoms.

  • Lifestyle changes: Stress management, exercise, healthy weight, and assistive devices.

Can You Have Both Psoriatic Arthritis And Rheumatoid Arthritis?

It is possible to have both conditions at once. Up to 30% of people with psoriatic arthritis may also develop RA, as they share some inflammatory pathways.

Having psoriasis with joint pain often indicates psoriatic arthritis, but doctors may test for RA to rule out overlap.

When To Seek Care

If you have joint pain, swelling, or stiffness lasting more than three days, consult a healthcare provider. They may refer you to:

  • Rheumatologist: Specialist in autoimmune joint disease

  • Orthopedist: Joint and bone surgeon

  • Podiatrist: Foot and ankle specialist

  • Physical therapist: Helps strengthen and improve joint function

  • Occupational therapist: Guides on joint protection and pain reduction techniques

A Quick Review

Psoriatic arthritis and rheumatoid arthritis both cause joint inflammation due to immune system irregularities. Psoriatic arthritis often includes skin and nail symptoms, while rheumatoid arthritis commonly presents with systemic effects. They affect different body structures but can overlap, and both require medical care for management.