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.
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
In this article, we look at the connection between dactylitis and psoriatic arthritis.
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:
- infections, such as tuberculosis
- peripheral spondyloarthritis, a type of arthritis that also affects the spine
- sarcoidosis, which causes patches of swollen tissue to grow inside the body or on the skin
- osteoid osteoma, a noncancerous bone tumor
- sickle cell disease
It may appear with rheumatoid arthritis or osteoarthritis. However, it is not a typical symptom.
Psoriatic disease is an inflammatory condition that causes swelling and pain in the joints. It may follow a pattern of flaring up and subsiding.
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
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
Dactylitis involves inflammation throughout the affected digit, including the:
- tendon sheaths
- 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
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.
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.
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
- disease-modifying antirheumatic drugs (DMARDs), for example, methotrexate
- biologics, for instance, adalimumab (Humira)
- corticosteroid injections, in some cases, to reduce inflammation
- lifestyle measures, such as weight management, physical therapy, exercise, and quitting smoking
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.
Some home remedies may help support treatment as well.
People can try:
- using cold or heat treatments, such as ice wrapped in a towel or a warm soak or warming gel
- performing gentle foot or hand exercises to keep the digits moving
- following a diet that is suitable for people with 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.