The hormonal changes leading up to and during menstruation as well as throughout pregnancy can cause whole-body fluid retention, but common localized sites of swelling include hands and feet. While the hormonal changes can’t always be treated, swelling can be managed with different treatment options. The primary symptoms of dactylitis are swollen, painful digits and difficulty moving the affected areas. Dactylitis can also be a sign of more severe PsA and more joint damage. If you notice swelling in your fingers or toes, make an appointment with the doctor who treats your PsA. Steroid injections, which are administered directly into the affected digits, quickly reduce inflammation and ease discomfort.



Dactylitis is severe inflammation of the finger or toe tendons and joints, making them look like sausages. You may experience pain in the affected joints and a reduced range of motion.

Outlook For People With Dactylitis

This inflammation produces swelling all the way down the finger or toe. Fingers and toes affected by dactylitis become swollen or appear sausagelike.

• 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.
• Descriptive statistics were used to describe the patient population.
• The causes of dactylitis are many and can range from factors out of your control (genetics) to those you can change (lifestyle modifications).
• The third digit (middle finger) was the second most commonly involved.

It’s good to know why your body is creating this type of inflammation. Seeing a doctor will identify the cause of your dactylitis, which can help you find the right solutions, get the quickest relief possible, and keep future flare-ups atbay.

Psoriatic Arthritis

In the feet the fourth digit was the most often affected, again usually bilaterally (table 2). Of the 537 patients registered in the psoriatic arthritis clinic between 1979 and 1999, 260 (48%) had at least one episode of acute dactylitis. One hundred and eighty patients (69%) had dactylitis at their first clinic visit. Thus the prevalence of dactylitis at presentation to the clinic was 33.5%. One hundred and forty eight of the 260 patients with dactylitis (57%) were male and 43% were female (table 1).

• Like dactylitis in the fingers, the inflammation in the toes can cause a swollen, sausagelike appearance as it spreads.
• The database was searched for the presence of dactylitis, and all records were reviewed to confirm the presence of dactylitis and the sites at which it occurred.
• Dactylitis occurs commonly among patients with psoriatic arthritis.
• Dactylitis is one of the hallmark features of the spondyloarthropathies, and especially psoriatic arthritis.

When you have PsA, you can experience skin symptoms and joint pain on one or both sides of your body and psoriasis, scaly, itchy patches of skin, anywhere on your body. Dactylitis occurs commonly among patients with psoriatic arthritis. It can be destructive, and its presence should prompt the physician to start specific treatment. Your doctor will diagnose dactylitis based on a physical examination, X-rays or MRI (magnetic resonance imaging) scans, and your symptom history. You will also likely be tested for various biomarkers, or indicators, in your blood that can provide a better idea of current levels of inflammation or damage.

Dactylitis Causes

There’s no cure for PsA, but there are treatments that can help you manage your symptoms. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) or disease-modifying antirheumatic drugs (DMARDs). Some treatments you already take to manage your PsA can help bring down the swelling in your fingers and toes. Sticking with your treatment plan will help to ensure that dactylitis doesn’t become a long-term problem. To figure out whether you have this condition, your doctor will measure the swelling in your fingers and toes. Your doctor will also squeeze the affected digits and ask how much it hurts.

• MRI studies suggest that dactylitis is primarily an inflammation of the flexor tenosynovial sheaths, with limited joint involvement.
• Because these pulley sites are under frequent pressure as they rub against bone, they are prone to inflammation, which researchers have suggested causes the changes in physical function seen in enthesitis alongside dactylitis.
• The swollen fingers or toes can be tender or painful, and sometimes red and warm to the touch.
• Information on the exact digit involved was available for 259 patients.

Generally speaking, dactylitis results from systemic (widespread) inflammatory conditions, including psoriatic arthritis. In people with PsA, the body’s immune response overreacts, leading to inflammation and the resulting symptoms of psoriatic arthritis. Dactylitis involves the small joints of the fingers and toes and the areas where tendons and ligaments insert into the bone become inflamed.

Treatment For Reactive Arthritis

Thus 201 (78%) of the patients had dactylitis in the feet, and 89 (34%) in the hands. The mean number of digits with dactylitis in the feet was 1.7 (range 0 to 10) and in the hands it was 0.6 (range 0 to 6). The most frequently affected digit in both hands was the second digit (the index finger). The third digit (middle finger) was the second most commonly involved.

• Doctors may use a combination of medications to help manage psoriatic arthritis and dactylitis, including anti-inflammatory drugs and corticosteroids.
• Dactylitis affects nearly 40 percent of people with psoriatic arthritis.
• Up to 30% of people with the skin condition psoriasis develop PsA, according to a 2018 literature review.
• Along with joint pain, swelling, and stiffness, psoriatic arthritis can cause dactylitis — inflammation in the fingers or toes.
• Their mean (SD) age was 42 (12.8) years, which was on average 8.0 (8.7) years after the onset of psoriatic arthritis.

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