This is the case of a patient who for many years presented with typical features of RA. When new findings such as skin psoriasis with asymmetrical, destructive and proliferative changes of the DIP joints of the feet presented, the previous diagnosis had to be reviewed. The clinical distinction between RA and PsA diagnosis in this patient is very difficult to establish. Currently the clinical and radiological picture of the patient’s hands is typical for RA, whereas the feet are typical for PsA. Other available tests have not been conclusive for the final diagnosis as well. There is no case of a patient with RA and PsA overlap syndrome reported so far in the literature. It appears that in this patient such a diagnosis should be seriously considered. However, it needs to be underlined that according to the present criteria such cases are diagnosed as PsA.