Psoriatic arthritis

Question 1

10-40% of patients with ______ develop psoriatic arthritis in 10 years

Answer 1

psoriasis

Question 2

What are symptoms of moderate psoriatic arthritis?

Answer 2

Inflamed DIP joints
Nail dystrophy and pitting
Onycholysis
Dactylitis
Enthesitis

Question 3

Where are some good places to check for psoriatic rash on skin?

Answer 3

Behind ears
Scalp
Under nails
Penile

Question 4

What are extra symptoms in severe arthritis?

Answer 4

Arthritis mutilans (short fingers and toes due to bone resorption)

Pencil in cup deformity (osteolysis of bone is progressive, shortening and fingers telescope in on themselves)

Question 5

How do you treat psoriatic arthritis?

Answer 5

NSAIDs
If severe, steroid injection

DMARD = methotrexate

2nd line = Infliximab (TNF-a inhibitor)

3rd line = IL 12 + 23 inhibitor (Ustekinumab)

Question 6

Psoriatic arthritis may be associated with u_____ and I__

Answer 6

uveitis and IBD

Question 7

What tool is suggested by NICE to screen for psoriatic arthritis in patients with psoriasis?

Answer 7

PEST (psoriasis Epidemiological Screening Tool)

High score indicates referral to a rheumatologist

Question 8

What are characteristic X-ray changes in psoriatic arthritis?

Answer 8

Pencil-in-cup appearance due to erosion on one side of joint.
Periostitis
Ankylosis
Osteolysis
Datylitis

Question 9

What are risk factors for psoriatic arthritis?

Answer 9

HLA-B27
HLA-Cw6
Obesity
30-50 y/o
Family history