Psoriatic Arthritis Flashcards
what is psoriatic arthritis?
INFLAMMATORY arthritis
a/w psoriasis
seronegative spondyloarthropathies
psoriatic arthritis correlates poorly with?
cutaneous psoriasis
psoriatic arthritis precedes?
development of skin lesions
sex difference in psoriatic arthritis?
equal
presentation pattern of psoriatic arthritis?
symmetric polyarthritis (most common type) - dip and pip
asymmetric oligoarthritis (hands and feet typically) - dip and pip
sacroilitis
dip joint disease
arthritis mutilans
psoriatic skin lesions
periarticular disease
nail changes
what is arthritis mutilans?
severe deformity fingers/hand
‘telescoping fingers’
what periarticular disease can be seen in psoriatic arthritis?
tenosynovitis and soft tissue inflammation resulting in
- enthesitis
- tenosynovitis typically of flexor tendons of hands
- dactylitis - diffuse swelling of finger or toe
what’s enthesitis
inflammation at site of tendon/ligament insertion (e.g. achilles tendonitis, plantar fasciitis)
ix of psoriatic arth?
xray - unusual combination of erosive changes + bone formation
periostitis
pencil in cup appearance
mx of psoriatic arth?
similar to RA but differences are:
-mild peripheral arthritis/axial disease: just an NSAID rather than DMARD
- mAb - ustekinumab, secukinumab
better prognosis than RA
moa of ustekinumab
targets il-12 and il-23
moa of secukinumab
targets il-17
what is onycholysis?
separation of nail plate from nailbed
commonly a/w psoriasis
what is dactylitis?
inflammation of a digit
what are causes of dactylitis?
spondyloarthritis: e.g. Psoriatic and reactive arthritis
sickle-cell disease
other rare causes include tuberculosis, sarcoidosis and syphilis
