Psoriatic arthopathy Flashcards
1
Q
What starts first: psoriasis or psoriatic arthritis?
A
- Psoriasis before psoriatic arthritis in 60-80% of patients
- Psoriatic arthritis before psoriasis in 15-20% (many with FHx of psoriasis)
- Occasionally, arthritis and psoriasis appear simultaneously
2
Q
Types of psoriatic arthritis
A
- rheumatoid-like polyarthritis: (30-40%, most common type)
- asymmetrical oligoarthritis: typically affects hands and feet (20-30%)
- sacroilitis
- DIP joint disease (10%)
- arthritis mutilans (severe deformity fingers/hand, ‘telescoping fingers’)
3
Q
(3) possible articular manifestations of psoriatic arthritis
A
- Synovitis
- Enthesitis → inflammation at tendon or ligament insertions into bone
- Enthesopathy → observed more often at the attachment of the Achilles tendon and the plantar fascia to the calcaneus with the development of insertional spurs
4
Q
What’s that?
A
Dactylitis - sausage-shaped fingers (may be sign of psoriatic arthropathy)
5
Q
What joints are commonly affected by psoriatic arthritis?
A
6
Q
Criteria used in the diagnosis of psoriatic arthritis
A
7
Q
Investigations for psoriatic arthritis
A
- ESR & CRP
- FBC
- U&E
- LFT
- Rheumatoid factor +/or Anti-CCP antibodies
- HLA B27 if suspecting spondyloarthropathy
- Imaging:
- X-Ray → sacroiliac joints
- USS or MRI → affected joints area
8
Q
Management of Psoriatic arthritis
A
- should be managed by a rheumatologist
- treat as rheumatoid arthritis but better prognosis
9
Q
What’s that?
A
Pencil in cup appearance
Changes affecting both the PIPs and DIPs
The close-up images show extensive changes including large eccentric erosions, tuft resorption and progression towards a ‘pencil-in-cup’ changes
10
Q
Psoriatic nail changes
A
