Musculoskeletal symptoms predict psoriatic arthritis

(HealthDay)—For patients with psoriasis, nonspecific musculoskeletal symptoms, including joint pain, fatigue, and stiffness, predict the development of psoriatic arthritis (PsA), according to a study published in the March issue of Arthritis & Rheumatology.

Lihi Eder, M.D., Ph.D., from the University of Toronto, and colleagues conducted a prospective cohort study involving patients with psoriasis who were assessed at baseline and reassessed annually to examine development of clinical PsA. At each visit, the presence of musculoskeletal symptoms and the patients' assessments of pain, fatigue, stiffness, physical function, and psychological distress were recorded.

The researchers found that 57 of 410 patients with psoriasis developed PsA. Prediction of subsequent PsA was associated with baseline presence of arthralgia in women (hazard ratio [HR], 2.59), heel pain (HR, 4.18), high fatigue score (HR, 2.36), and high stiffness score (HR, 2.03). Increases from baseline in fatigue, pain, and stiffness scores (HRs, 1.27, 1.34, and 1.21, respectively), and a worsening in physical function score (HR, 0.96) also predicted PsA development.

"A preclinical phase exists in patients with PsA prior to the diagnosis of the disease," the authors write. "This phase is characterized by nonspecific musculoskeletal symptoms, including joint pain, fatigue, and stiffness."