Psoriatic arthritis (PsA) is a type of inflammatory arthritis that usually happens alongside the skin condition psoriasis. Experts estimate that PsA affects about 20% of people with psoriasis.

There are several different types of PsA. One of the most common types is asymmetric oligoarticular PsA. That’s PsA that affects only a few joints on one side of your body.

Keep reading as we cover what to know about asymmetric oligoarticular PsA, including its causes and symptoms, as well as how doctors diagnose and treat it.

Definitions

Before we get started, let’s go over some definitions that will be helpful along the way.

  • Asymmetric: When something is asymmetric, it affects the two sides of your body differently.
  • Oligo: The term oligo means a few or a little of something.
  • Articular: Articular is a word that means something related to your joints.

Generally speaking, there are five different types of PsA. These are:

  • Asymmetric oligoarticular: Asymmetric oligoarticular PsA involves only a few joints on one side of your body. It affects about 60% of people with PsA.
  • Symmetric polyarthritis: Symmetric polyarthritis affects more joints than asymmetric oligoarticular PsA. It also affects joints on both sides of your body. Between 15% and 61% of people with PsA have this type.
  • Distal interphalangeal: Distal interphalangeal PsA mainly affects the ends of your fingers and toes. Nail changes are particularly common in this type of PsA. It has an incidence of about 10%.
  • Spondylitis: Spondylitis PsA affects the joints between your vertebrae. This can lead to back and neck pain as well as difficulty with movement. Experts think it affects between 7% and 32% of people with PsA.
  • Arthritis mutilans: Arthritis mutilans is the most severe type of PsA. In this type of PsA, inflammation is very severe and can lead to joint deformation, particularly in your hands and feet. Less than 5% of people with PsA have this type.

It’s possible to have more than one type of PsA. For example, you can have asymmetric oligoarticular PsA that also occurs with spondylitis PsA.

Asymmetric vs. symmetric PsA

Let’s take a moment to summarize what we know about asymmetric versus symmetric PsA:

  • Asymmetric PsA only affects one side of your body, while symmetric PsA affects both sides of your body.
  • In asymmetric PsA, only a few joints are affected. More joints are involved in symmetric PsA.
  • Asymmetric PsA can impact both small and large joints. Symmetric PsA typically involves smaller joints, such as those in your hands and feet.
  • Symmetric PsA can be more severe than asymmetric PsA. A 2021 study found that compared with oligoarticular PsA, people with polyarthritis more often experienced dactylitis and enthesitis.

Both types of PsA are prevalent. A 2019 review notes that many people start out with asymmetric PsA and develop symmetrical PsA as the disease progresses.

In fact, a 2018 article notes that this disease progression, along with the sometimes inconsistent definitions of the PsA types, may explain some of the variability in prevalence between these two types.

Like psoriasis, PsA is an autoimmune disease. That’s when your immune system mistakenly responds to healthy tissues as if they were infected. When this happens, it can lead to increased inflammation and pain as well as tissue damage.

At this point in time, the exact cause of PsA is unclear.

Genetics very likely plays a role. Researchers have identified variations in certain genes associated with PsA. Further, about 33% to 50% of people with PsA know of at least one other close relative with psoriasis or PsA.

Environmental factors such as infection, physical injury, or high stress may also be important. These factors may help to trigger the onset of PsA in people who are already genetically predisposed to the condition.

The hallmark of asymmetric oligoarticular PsA is that it affects a small number of joints, typically less than five, on one side of your body. While it often impacts small joints in your hands and feet, larger joints such as your knee can also be involved.

This type of PsA can cause symptoms such as:

Because PsA is associated with psoriasis, you can also experience skin symptoms. Psoriasis is typically characterized by patches of skin that are inflamed, scaly, and itchy.

If asymmetric oligoarticular PsA occurs with spondylitis PsA, you may also have pain or stiffness in your back, neck, or hips.

PsA can be tricky to diagnose because it can be very similar to other conditions that affect the joints. For example, a doctor might misdiagnose asymmetric oligoarticular PsA as osteoarthritis, gout, or reactive arthritis.

But a thorough physical exam, medical history, and careful testing can help rule out other conditions.

During a physical exam, a doctor will take a look at your affected joints. When getting your medical history, they may ask you:

  • How many of your joints are affected, and where are they?
  • What types of symptoms do you have, and when did they start?
  • How severe are your symptoms, and does anything make them better or worse?
  • Has a doctor given you a diagnosis of psoriasis or another underlying medical condition?
  • Does psoriasis or other medical condition run in your family?

To help determine the cause of your symptoms, a doctor will order further tests. Imaging tests such as X-rays can help them look at your joints. Blood tests can look for signs of inflammation and help to rule out other conditions.

Generally speaking, you can treat PsA with a combination of medical treatments and home management. Overall, the goals of PsA treatment are to:

  • reduce your symptoms
  • prevent flare-ups
  • slow or halt disease progression
  • improve or keep up the range of motion of your joints
  • boost your quality of life

Medical treatment

Doctors use several different drug types to treat PsA. Which one they select can depend on factors such as the severity and extent of your symptoms as well as which medications, if any, they’ve tried previously.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs are available over the counter and can include drugs such as ibuprofen (Advil and Motrin) and naproxen (Aleve). They may help if your PsA symptoms are mild.
  • Corticosteroids: Corticosteroids can reduce inflammation. You take them either by mouth or by injection at the affected joint. Doctors try to use them sparingly due to their potential side effects.
  • Disease-modifying antirheumatic drugs (DMARDs): DMARDs also work to reduce inflammation and can help slow the progression of PsA. There are different types of DMARDs:
    • Traditional DMARDs such as methotrexate or sulfasalazine broadly reduce the activity of your immune system.
    • Biologics such as adalimumab (Humira) and infliximab (Remicade) work by targeting the specific inflammation pathways associated with PsA.

Surgery is uncommon in PsA. But a doctor may recommend it when the effects of PsA have led to severe joint damage or deformation.

Home management

After giving you a diagnosis of PsA, a doctor may also recommend physical therapy. A physical therapist can work with you to teach you exercises that you can do to improve or keep up your strength, flexibility, and range of motion.

If PsA has affected your ability to do your daily activities, occupational therapy may also be helpful. An occupational therapist works with you to develop strategies on how to best perform daily activities related to home, work, or school.

There are other things you can do at home to help with PsA:

When left untreated, PsA can cause significant discomfort and affect your daily activities and quality of life. People with very severe PsA may develop deformation in their affected joints.

But it’s possible to manage PsA and slow its progression through a combination of medications and at-home care. Surgery for the condition is rarely needed.

It’s also possible for asymmetric oligoarticular PsA to progress over time into symmetric polyarticular PsA, which affects more joints and can have more severe symptoms.

As such, it’s important to have regular check-ins with a doctor if you have this type, or any type, of PsA. They can do tests to help monitor your condition and catch any signs of progression early.

Asymmetric oligoarticular PsA is one of the five types of PsA. It’s one of the most common types of PsA and impacts a small number of joints on one side of your body.

You can typically treat PsA with a combination of medications and at-home care. Together, these treatments can help relieve symptoms, slow the progression of the condition, and improve your quality of life.

As time passes, asymmetric oligoarticular PsA can progress to symmetric polyarticular PsA, which affects more joints on both sides of your body. Because of this, if you have PsA, try to have regular checkups to monitor your condition.