Q: I am a 21 years old boy having psoriatic arthritis for the last year and now have a swollen knee with pain. I get cold fever sometimes. I have lost around 10 kg weight and lost fat from my thighs and buttocks. I find it hard to walk not just because of knee pain but also due to lack of strength in my legs. Is this due to psoriatic arthritis? My blood reports show elevated ESO (99) and ASO titre (1600).

A:The diagnosis of psoriatic arthritis can be difficult if skin lesions are not there. However, in the presence of skin lesion the diagnosis is quiet straight forward. The arthritis associated with this can be quiet significant and crippling. Wasting of muscles especially of the thigh is common if there is significant involvement of the knee joint. The joint involved in this disease may vary from just the knee joints to multiple joints of the hand and even the trunk. The ESR is usually high suggesting active inflammation in the joint. Local applications do not significantly alter the course of the disease. Systemic medicines like; sulpha-salazine and methotrexate are usually effective in keeping the disease under control.