Psoriatic Arthritis

Question 1

What specific findings should you comment on during examination?

Answer 1

Nails are involved in 80% of Pt with Psoriatic Arthritis

• Pitting
• Onycholysis
• Discolouration
• Thickening

Psoriatic plaques on

• Extensor aspect of elbows
• Scalp
• Submammary region
• Umbilicus and natal cleft

Fingers
- Dactylitis as a result of tenosynovitis

Question 2

How would you describe psoriatic plaques?

Answer 2

Reddish plaques with well-defined edges and silvery white scales

Question 3

What is tenosynovitis?

Answer 3

Inflammation of the fluid filled sheath (synovium) that surrounds a tendon

Question 4

What are the radiological findings of psoriatic arthritis?

Answer 4

1. Fluffy periostitis
2. Destruction of small joints
3. Arthritis mutilans
4. Non-marginal syndesmophytes

Question 5

What is arthritis mutilans?

Answer 5

An extremely severe form of Rheumatoid or Psoriatic arthritis.

Characterised by bone resorption and collapse of soft tissue resulting in ‘telescoping’.

Question 6

What are the management options in psoriatic arthritis?

Answer 6

NSAIDs e.g. Indomethacin
Selective COX-2 inhibitors
Intraarticular glucocorticoid injections
DMARDs