PSORIATIC ARTHRITIS Flashcards
Define psoriatic arthritis.
Chronic autoimmune inflammatory arthritis associated with psoriasis.
What is psoriasis?
Psoriasis is a common condition where there is inflammation of the skin. It typically develops as patches (plaques) of red, scaly skin. Once you develop psoriasis it tends to come and go throughout life.
Is psoriasis infectious?
No.
What percentage of psoriasis sufferers develop arthritis?
8%
What are the different types of psoriatic arthritis?
Seronegative symmetrical polyarthritis Asymmetric oligoarticular arthritis Lone distal interphalangeal arthritis Arthritis mutilans Spondylitic pattern +/- sacroiliitis Juvenile onset psoriatic arthritis
Which joints are most often affected in seronegative symmetrical polyarthritis?
Wrists
Ankles
Feet
Fingers
On examination, how might you differentiate seronegative symmetrical polyarthritis from rheumatoid arthritis?
The DIP joints are often involved rather than the MCP joints
No skin nodules
Which joints are most commonly affected by asymmetric oligoarticular arthritis?
Hands
Feet
How many joints, by definition, are affected by asymmetric oligoarticular arthritis?
Oligo – 1-5 joints
Other than joint pain, what signs and symptoms might be present in someone with asymmetric oligoarticular arthritis?
Enthesopathy Dactylitis Nail dystrophy Cutaneous lesions (psoriasis) Interphalangeal joint synovitis Tenosynovitis
Which joints are most affected by lone distal interphalangeal disease?
Distal interphalangeal joints
Are men or women more likely to develop lone distal interphalangeal disease?
Men
How is the affected nail and DIP described in someone with lone distal interphalangeal disease?
Hammer blow appearance
Which joints are most often affected in arthritis mutilans?
DIP
PIP
Other than joint pain, what other signs might be seen in the hand of someone with arthritis mutilans?
Telescoping
What causes telescoping in the fingers of patients with arthritis mutilans?
Periarticular osteolysis and bone shortening
What percentage of patients with psoriatic arthritis are affected by arthritis mutilans?
5%
Are men or women more likely to develop the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?
Men
What are the symptoms of the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?
Morning back stiffness
Movement limitation
What might be seen on the radiograph of someone with the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?
Syndesmophytes
Paravertebral ossification
Fusion of vertebral bodies
Calcified intervertebral discs
Are vertebrae affected symmetrically or asymmetrically in the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?
Asymmetrically
From a radiograph, how might you diagnose the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis instead of ankylosing spondylitis?
In ankylosing spondylitis, vertebrae are normally affected symmetrical. This is not the case in the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis.
What are the CASPAR diagnostic criteria for diagnosing psoriatic arthritis?
Inflammatory articular disease plus 3 points worth of the following:
Psoriasis (2) History of psoriasis (1) Family history of psoriasis (1) Psoriatic nail dystrophy (1) Negative RF (1) Current dactylitis (1) History of dactylitis (1) Jaxta-artciular new bone (1)
What the pharmacological treatment options for patients with psoriatic arthritis?
DMARDs (Leflunomide, Sulfasalazine, Methotrexate)
NSAIDs
Steroid injections
Cytokine modulators (adalimumab, etanercept, golimumab and infliximab)
Why might oral steroids not be a good treatment option in someone with psoriatic arthritis?
Oral steroids may cause rebound exacerbations of skin lesions.
What group of diseases does psoriatic arthritis fall under?
Seronegative Spondyloarthropathies
What is the surface antigen associated with psoriatic arthritis?
HLA-B27
