Psoriatic Arthritis Flashcards
What is psoriatic arthritis?
An inflammatory arthritis associated with psoriasis. It is one of the seronegative spondyloarthropathies.
What is arthritis mutilans?
When the joint is completely destroyed by arthritis- the most severe stage of psoriatric arthritis
What proportion of psoriasis patients will get psoriatic arthritis?
10-20%
In what age group is it most common?
Middle age
What affected joint patterns may it show?
- Symmetrical polyarthritis
- Asymmetrical pauciarthritis
- Spondylitic pattern
- Other joints that may be involved
What is symmetrical polyarthritis?
- Hands, wrists, ankles and DIP joints are commonly affected on both sides
- Similar to RA, and more common in women.
- Unlike RA, the MCP joints are less commonly affected
What is asymmetrical pauciarthritis?
- Affects mainly the digits (fingers and toes) and feet
- Pauciarthritis means an arthritis affecting only a few joints
What is a spondylitic pattern?
- Back stiffness, sacroiliitis, atlanto-axial joint involvement (C1 and 2)
- More common in men
Which other joints may be involved?
- Spine
- Achilles tendon
- Plantar fascia
What signs may be seen on examination?
- PSORIATIC PLAQUES ON THE SKIN
- Nail pitting
- Onycholysis (separation of the nail from the bed)
- Dactylitis (full finger inflammation)
- Enthesitis (inflamed entheses- where a tendon meets the bone)
What other associations are there to the disease?
Eye- conjunctivitis, anterior uveitis
Aortitis
Amyloidosis
What tool is used to screen for it?
PEST (Psoriasis epidemiological screening tool)
What XR changes may be observed?
- Periostitis (thickened, irregular bone outline)
- Ankylosis (bones join together, stiffens)
- Osteolysis (bone destruction)
- Dactylitis (whole finger inflammation- soft tissue swelling)
- Pencil in cup (central bone erosion beside a joint- one bone appears hollow like a cup, with the other bone in the joint looking like a narrow pencil sitting in it)
What is a spondyloarthropathy?
Arthritis affecting the spine or nearby joints
Where does arthritis mutilans occur?
The phalanges
