Can psoriatic arthritis flares be precipitated by an injury?

Joint pain

Synopsis

While it is true that injury to the skin can trigger psoriasis symptoms for some people (this is known as the Koebner phenomenon), it is not clear that there is a similar phenomenon for psoriatic arthritis.

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Expert Answers

Dr. Ron Vender:

There is no clear association between arthritis and injury. The Koebner phenomenon is a well described phenomenon of the skin, where injury of the skin can elicit psoriatic skin disease. Does injury precipitate arthritis or a deep Koebner phenomenon? Another consideration could be that the injury is coincidental with discovering arthritis as well. Chart reviews in the literature have shown that there is an association in only 10% of cases and therefore maybe by mere chance. Measures must be taken to ensure that proper exercise is common practice during a daily routine to ensure that the joints and muscles have enough strength so that in rare cases of injury there is no arthritic flare.

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Sandra Walsh:

It is known that trauma to the skin can be a trigger for some people’s psoriasis. This is known as the Koebner phenomenon. Is there a similar phenomenon for psoriatic arthritis? There have been case reports of PsA flaring after trauma and it was first written about in 1959. It was unclear for many years as to whether the trauma was the trigger for the arthritis or if it was a coincidental finding. It remains controversial, but many rheumatologists do believe that there is enough evidence that trauma is a trigger for the condition but there is less evidence for its role in subsequent flares. What remains unclear is why some people are prone to this phenomenon and others are not.

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Painful joints might hide something else

I want to know what it is