Symmetric Arthritis- similar to Rheumatoid Arthritis, generally milder with less deformity. This usually affects multiple symmetric pairs of joints, on both sides of the body. Can be disabling.
Asymmetric Arthritis- can involve a few or many joints, does not occur in the same joint on both sides of the body. The hands and feet may have enlarged 'sausage digits', and the joints may be red, tender, and warm. Periodic pain may be experienced that responds well to medical therapy. This form is usually mild, but can be disabling.
Distal Interphalangeal Predominant (DIP)- Considered to be 'classic type arthritis', yet only occuring in about 5% of Psoriatic Arthritis patients. This mainly affects the distal joints of the fingers and toes (joints closest to the nail). This is sometimes confused with Osteoarthritis, but nail changes are usually prominent.
Spondylitis- is inflammation of the spinal column, in approximately 5% of all Psoriatic Arthritis sufferers, Spondylitis is the predominant symptom. Inflammation with stiffness of the neck, lower back, sacroiliac or spinal vertebrae are common in the larger number of patients, making motion painful and difficult. Pheripheral (outer area, situated away from the center) disease can be present in the arms, hands, legs, feet and hips.
Arthritis Mutilans- is a severe, deforming, destructive arthritis that affects fewer than 5% of all Psoriatic Arthritis sufferers. It mainly affects the small joints of the hands and feet, though it can also be associated with the lower back.
Not sure what you are asking... From all that I have read, these symptoms, can appear, flare up then disappear, can reappear, evolve from one into the other, it's complicated. So this post is to just let the newbies know of the types or provide the very simplist of explanations to those recently diagnosed. A Rheumatologist is the Doctor best qualified to diagnose the disease and the type.
Surely the area that ails you the most would direct the doctor to the area to x-ray.
According to most of my research, 80% of people who have Psoriasis have PsA. I do not have any skin rash, but I do have pitted fingernails, another sign. Blood tests can show anemia or elevated erythrocyte sedimentation rate (ESR) which will give them an idea of the inflammation level of the body, (this could be elevated by other factors) but there really is no standard blood test, they may look for a Rheumatoid factor to eliminate Rheumatoid Arthritis.
Physical exam, family history of Psoriasis, PsA, x-rays all help a specialist (Rheumatologist) make the diagnosis. If psoriasis is not present, in the patient or the family, and my Rheum seems to think that it is always somewhere in the family, the specialists has a more difficult job.
Go to a good GP or internist who will refer you to Michael M Rezaian, the Rheumatologist, and let him tell you. Really! He is asst prof of WVU, or go to Hopkins, or University of MD or Georgetown Univ. and let them challenge this Doctor. Really!