Psoriatic Arthritis

Question 1

What is psoriatic arthritis?

Answer 1

An inflammatory arthritis associated with psoriasis

Question 2

What are the patterns of psoriatic arthritis?

Answer 2

Symmetrical polyarthritis
Asymmetrical polyarthritis
DIP predominant pattern
Spondylitis
Arthritis mutilans

Question 3

What is asymmetrical polyarthritis?

Answer 3

Affects 1-4 joints at any given time, often only on one side of the body

Question 4

What is symmetrical polyarthritis?

Answer 4

Presents similarly to rheumatoid arthritis - more than four joints affected, such as the hands, wrists and ankles

Question 5

What is DIP predominant arthritis?

Answer 5

Primarily affects the DIP joints (however the DIP joints can be affected in all types of psoriatic arthritis)

Question 6

What is spondylitis?

Answer 6

Involves the axial skeleton and presents with back stiffness and pain

Question 7

What is arthritis mutilans?

Answer 7

Most severe form of psoriatic arthritis. There is osteolysis of the bones around the joints in the phalanges, leading to progressive shortening of the digits.

Question 8

What are the signs of psoriatic arthritis?

Answer 8

Plaques of psoriasis on the skin
Nail pitting
Onycholysis (separation of the nail from the nail bed)
Dactylitis
Enthesitis

Question 9

What screening tool is used for psoriatic arthritis?

Answer 9

PEST (psoriasis epidemiological screening tool)

Question 10

What X-ray changes are seen in psoriatic arthritis?

Answer 10

Periostitis (inflammation of the periosteum causes a thickened and irregular outline of bone)
Ankylosis (fixation or fusion of the bones at the joint)
Osteolysis
Dactylitis

Question 11

What is the management of psoriatic arthritis?

Answer 11

NSAIDs
Steroids
DMARDs
Anti-TNF medications
Ustekinumab - monoclonal antibody that targets interleukin 12 and 13