How does psoriatic arthritis affect fingers and toes?

Psoriatic arthritis affects the fingers and toes primarily through a condition known as dactylitis, which manifests as a characteristic sausage-shaped swelling of the digits. As the disease progresses from an initial oligoarthritis to a polyarticular pattern, it frequently impacts the joints of the hands and feet.1

In severe cases, a rare and destructive form of the disease called arthritis mutilans—occurring in fewer than 5 percent of patients—can lead to significant bone destruction. This results in a clinical presentation known as "telescoping" of the fingers or toes, where the digits appear to shorten due to the underlying joint damage. Unlike rheumatoid arthritis, the polyarticular pattern of psoriatic arthritis typically involves a different subset of finger joints.1