Dactylitis describes painful swelling in the fingers or toes, giving it a sausage-like appearance. It may be the first sign of psoriatic arthritis. It may also be a sign of severe underlying disease.

Dactylitis means inflammation of a digit. It involves an overall swelling of one or more fingers or toes. It is a symptom of various conditions. However, it has close links with psoriatic arthritis.

Psoriatic arthritis involves inflammation in the joints, tendons, and ligaments, and dactylitis refers to pain and swelling in the fingers or toes. Psoriatic arthritis is a type of psoriatic disease. Often, the person will have a history of skin symptoms.

Psoriatic arthritis is a serious disease. However, various treatment approaches can help manage symptoms, slow progression, and reduce the risk of flares and complications.

In this article, we look at the connection between dactylitis and psoriatic arthritis.

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Infographic by Bailey Mariner

Dactylitis and psoriatic arthritis both involve inflammation. However, they are separate conditions.


Dactylitis involves inflammation in a digit, meaning a finger or toe. The affected digits become painfully swollen and lose some of their definition. Due to this effect, people commonly refer to the condition as “sausage fingers.”

The inflammation occurs in many tissues throughout the digit, making it painful and even impossible to use at times.

There are different types of dactylitis. However, most involve systemic inflammation. This means inflammation that occurs throughout the body.

In addition to psoriatic arthritis, dactylitis can occur with:

It may appear with rheumatoid arthritis or osteoarthritis. However, it is not a typical symptom.

Learn more about dactylitis here.

Psoriatic arthritis

Psoriatic arthritis is a psoriatic disease and a form of arthritis. It affects about 20% of people who have psoriasis.

Psoriatic disease is an inflammatory condition that causes swelling and pain in the joints. It may follow a pattern of flaring up and subsiding.

Around 68% of people who receive a diagnosis of psoriatic arthritis have a history of psoriasis, and around 15% develop skin symptoms after psoriatic arthritis appears. In some cases, psoriatic arthritis and skin symptoms appear at the same time.

Learn more about psoriatic arthritis here.

Connection between the two

Dactylitis is a hallmark symptom of psoriatic arthritis. Both conditions stem from systemic inflammation affecting the joints and tendons.

According to a 2015 research article, an estimated 39% of people with psoriatic arthritis also develop dactylitis.

More than half of the participants with dactylitis had their first flare-up before their arthritis diagnosis. In some people, dactylitis is the only symptom of psoriatic arthritis for months to years.

Psoriatic arthritis is a chronic inflammatory arthritis. It results from a faulty immune response that affects the skin and joints. It often runs in families and appears to have a genetic link. Some environmental factors, such as exposure to certain bacteria, may also play a role.

Dactylitis involves inflammation throughout the affected digit, including the:

  • ligaments
  • tendons
  • tendon sheaths
  • synovium

Experts believe dactylitis may result from a combination of:

  • tenosynovitis, an inflammation that affects the sheaths that surround the tendons
  • enthesitis, inflammation that occurs where the tendons and ligaments connect to a joint
  • soft tissue inflammation
  • erosive joint damage

It is unclear why dactylitis occurs with psoriatic arthritis rather than other forms of arthritis.

Dactylitis can lead to swelling anywhere in the finger or toe.

Dactylitis swelling is asymmetrical, affecting different areas on either side of the body. In people with psoriatic arthritis, it is more common for dactylitis to occur in the toes.

The affected digits may bulge and feel stiff. The skin may feel as though it is pulling too tight over the digit. Some people describe a feeling of the digit being about to burst.

Movement of the joints in the digit may be painful or very difficult and interrupt everyday activities. It may hurt to touch the digit or for the digit to come into contact with anything at all.

If a person sees a doctor with swollen fingers or toes, the doctor will likely:

  • carry out a physical examination, including assessing for skin symptoms
  • ask about the person’s individual and family medical history
  • recommend blood and imaging tests to try to identify the reason

Early diagnosis of psoriatic arthritis is key, as prompt treatment can reduce the risk of severe symptoms and complications.

Which tests can help diagnose psoriatic arthritis?

Dactylitis is a characteristic symptom of psoriatic arthritis. The inflammation involved can damage and erode the affected joints. It is a marker for disease severity, as significantly more damage occurs in the joints with dactylitis than in unaffected joints.

People with psoriatic arthritis who experience new flare-ups of dactylitis should see a doctor to review their treatment. If flare-ups continue to occur, it may mean that the current treatment is no longer effective. Another approach may be necessary.

There may also be a link between dactylitis and complications from psoriatic arthritis. For example, a 2015 study found that people with psoriatic arthritis who also had dactylitis had a higher risk of future cardiovascular events, such as heart attack or stroke.

This may be because dactylitis is a sign of more advanced disease progression in people with psoriatic arthritis.

Early treatment can help prevent permanent damage to the joints.

Doctors may use a combination of medications to help manage psoriatic arthritis and dactylitis, including anti-inflammatory drugs and corticosteroids.

Options include:

All these options can have adverse effects. A doctor will explain the pros and cons of each and work with the individual to find a suitable option.

What are the latest drugs for psoriatic arthritis?

Home remedies

Some home remedies may help support treatment as well.

People can try:

Learn about home and natural remedies for psoriatic arthritis.

Dactylitis causes painful swelling of an entire digit, such as a finger or toe. It is a feature of psoriatic arthritis and can indicate increasing disease severity. Early diagnosis and treatment can help prevent damage to the joints in the digit.

Anyone noticing signs of dactylitis should speak with their doctor. Even in cases of known psoriatic arthritis, new symptoms such as dactylitis may indicate that current treatments are no longer effective.

Managing psoriatic arthritis and dactylitis may help prevent permanent damage to the joints.