Phoebe Phillips, a 29-year-old, says that she is facing the possibility of a double leg amputation after years of severe inflammatory arthritis damaged both her knees. The woman was diagnosed with psoriatic seronegative inflammatory oligoarthritis in March 2019, after her right knee suddenly became severely swollen and painful in late 2018. Over the years, she says she tried several medicines, including methotrexate, sulfasalazine, JAK inhibitors and biologic drugs, but her disease continued to progress. By April 2026, an X-ray showed that she had no cartilage remaining in her knees, which has made walking incredibly difficult.

"I've missed out on my entire adulthood so far," said Phoebe, according to a report in Mirror. "It's really the small things that are so much more important to me. Just to be able to go up and down a couple of stairs like a normal person.. Standing in the shower and not having to sit down - all the small stuff.

"I can't even sleep in a normal bed, I have a rail next to the toilet, and all those kinds of things that I just shouldn't have to be dealing with, if I'd have been taken more seriously sooner or listened to."

Phoebe says she needed to repeatedly advocate for herself and feels her concerns were not taken seriously early enough. She now has severely restricted movement, permanently bent legs and difficulty carrying out everyday activities such as climbing stairs, sleeping comfortably and standing in the shower. Doctors have advised that double knee replacement may be necessary and the procedure might have to be repeated every 10 years. She says she has also been warned that repeated replacement surgeries and bone loss could eventually make above-knee amputation necessary. However, Phoebe said that it is a risk she is willing to take.

What Is Psoriatic Arthritis?

Psoriatic arthritis (PsA) is a chronic inflammatory condition that affects the joints and can develop in people with psoriasis. It is an autoimmune disease, which means the immune system mistakenly attacks healthy tissues, causing inflammation.

Although psoriasis often appears as red, scaly skin patches, PsA can affect the joints even when skin symptoms are mild or absent. It may affect the knees, fingers, toes, ankles, elbows, spine and the joints connecting the spine to the pelvis. Unlike ordinary wear-and-tear arthritis, PsA can cause inflammation that progressively damages cartilage, bone and other structures around the joints if it is not adequately controlled.

Types Of Psoriatic Arthritis

Psoriatic arthritis can appear in different patterns. The main types include:

  • Asymmetric oligoarthritis: Affects a small number of joints, often on one side of the body
  • Symmetric polyarthritis: Affects several joints on both sides of the body and can resemble rheumatoid arthritis
  • Distal arthritis: Mainly affects the joints closest to the fingertips and toenails
  • Spondylitis: Causes inflammation and stiffness in the spine and sacroiliac joints
  • Arthritis mutilans: A rare but severe form that can cause major destruction of the joints and bones in the hands and feet

Warning Signs To Watch For

Symptoms can vary considerably, but common warning signs include:

  • Persistent joint pain, swelling or stiffness
  • Stiffness that is worse in the morning or after periods of inactivity
  • Swollen fingers or toes, sometimes described as "sausage digits"
  • Pain around the heels or where tendons attach to bones
  • Lower back or buttock pain linked to inflammation
  • Nail changes such as pitting, ridges or separation from the nail bed
  • Psoriasis or a history of psoriasis
  • Reduced movement or difficulty using an affected joint
  • Fatigue

What Causes Psoriatic Arthritis?

There is no single known cause. PsA develops through a combination of genetic, immune-system and environmental factors.

Genes can increase susceptibility, which is why having a close relative with psoriasis or PsA can raise the risk. The immune system then becomes abnormally activated and triggers inflammation in the joints, tendons and other tissues.

Certain environmental factors may also contribute, including infections, physical trauma and other immune triggers. However, having psoriasis does not mean a person will definitely develop PsA.

Who Is At Higher Risk?

People with psoriasis are at increased risk of developing PsA, particularly those with extensive skin disease or certain nail changes. A family history of psoriasis or PsA can also increase susceptibility.

PsA can develop at any age, although it commonly begins in adulthood. Other factors, including obesity, smoking and some environmental triggers, may also be associated with a higher risk. It is important to note that the condition can also occur in people who have not previously been diagnosed with psoriasis.

What Happens If Psoriatic Arthritis Is Not Controlled?

Persistent inflammation can gradually damage joints. Over time, this may lead to cartilage loss, bone damage, deformity, stiffness and significant loss of mobility.

People with severe disease may struggle with walking, working, exercising or performing routine activities. Chronic pain and fatigue can also affect sleep, mental wellbeing and quality of life. PsA is not limited to the joints. It is also linked with an increased risk of other health problems, including cardiovascular disease, obesity, diabetes, inflammatory bowel disease and eye inflammation. Therefore, regular medical monitoring is important.

Can Joint Damage Be Prevented?

There is currently no cure for PsA, but treatments can control inflammation and reduce the risk of permanent joint damage. Treatment may include conventional disease-modifying antirheumatic drugs, biologic medicines and targeted therapies, depending on the individual's symptoms and disease pattern.

Painkillers and physical therapy may help manage symptoms, but they do not necessarily control the underlying inflammation. Treatment therefore needs to focus on suppressing disease activity as well as improving movement.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.