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‘Sausage Fingers’ May Point to More Severe Psoriatic Arthritis, Including Bone Damage

Posted on February 18, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Maureen McNulty

  • Dactylitis, a condition in which the fingers or toes swell, is a common symptom of psoriatic arthritis (PsA).
  • In a new study, researchers found that when people with early-stage PsA had dactylitis, they were more likely to have other signs of severe disease.
  • Researchers urged people with PsA who develop dactylitis to tell their health care provider as soon as possible to prevent future bone damage.

Dactylitis, sometimes referred to as “sausage fingers and toes,” may signal more severe psoriatic arthritis, a new study reports. Characterized by swelling of the digits, dactylitis is a common symptom of PsA — and one that should not be ignored.

“Our study confirmed that dactylitis is a marker of disease severity,” Dr. Helena Marzo-Ortega, a consultant rheumatologist and senior author on the study, told MyPsoriasisTeam. “It is associated with more underlying joint inflammation and damage when we use ultrasound, but it may not be readily visible to the naked eye.”

Dactylitis — sometimes referred to a “sausage fingers and toes” — is a common symptom of PsA. A new study has found that dactylitis may suggest greater disease severity. (DermNet NZ)


Although the swelling may not cause pain, cautioned Dr. Marzo-Ortega, people shouldn’t ignore the symptom, as it could predict bone damage down the road.

“Previous studies performed years ago already showed that in the long run, dactylitis is associated with bone damage,” Dr. Marzo-Ortega said. “So taken together, this suggests that people with psoriasis who develop sausage fingers or toes should not ignore these, even if they don’t hurt. They are advised to consult with their [general practitioner] or dermatologist in order to get referred to a rheumatologist for further assessment and treatment.”

PsA Inflammation and Pain Are Worse for People With Dactylitis

In the study, researchers in the UK recruited 177 people with early-stage PsA who had not yet begun treatment. They looked at signs of severe disease in people with and without dactylitis. About half of the people in the study had dactylitis.

The study authors reported that people with dactylitis:

  • Were more likely to have tender or swollen joints
  • Had higher levels of C-reactive protein (CRP) in their blood, a marker of inflammation
  • Were more likely to have swelling in the joints, as measured by an ultrasound
  • Had a higher chance of having bone erosions (areas where the bone was abnormally broken down), as measured by an ultrasound

All of these factors have previously been linked to more severe PsA. They may be signs that a person would benefit from taking medication, such as a biologic disease-modifying antirheumatic drug (DMARD).

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here.

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