Psoriatic Arthritis Flashcards
What is psoriatic arthritis?
Inflammatory arthritis associated with psoriasis.
What is the name of the condition that completely destroys joints after psoriatic arthritis?
Arthritis mutilans
How commonly does psoriatic arthritis occur in those with psoriasis?
10-20% of psoriasis patients will develop psoriatic arthritis within 10 years of skin changes.
What group of conditions does psoriatic arthritis belong to?
Seronegative spondyloarthropathy group
What is the joint pattern affected in psoriatic arthritis?
- No single pattern, lots of variation
- Symmetrical polyarthritis - similar to RA
- Asymmetrical pauciarthritis - mainly digits and feet
- Spondylitic pattern - back stiffness, sacroiliitis, atlanto-axial joint involvement
What is this a presentation of?
Plaques on the skin, pitting of nails, onycholysis, inflammation of finger, may be associated inflammatory conditions, joint stiffening and soreness.
Psoriatic arthritis
Which inflammatory conditions is psoriatic arthritis associated with?
- Conjunctivitis and anterior uveitis
- Aortitis
- Amyloidosis
What screening tool is used for psoriatic arthritis?
Psoriasis epidemiological screening tool (PEST) - questions about joint pain, swelling, arthritis history, and nail pitting (high score refer to rheumatology)
What is this x-ray finding indicative of?
- Periostitis - thick and irregular bone outline
- Ankylosis - bone join together
- Osteolysis - bone destruction
- Dactylitis - soft tissue swelling of digits
- Pencil-in-cup appearance - central erosions of bone beside joints
Psoriatic arthritis
Where does arthritis mutilans occur and what does it cause?
- Phalanxes - osteolysis of bones around joints in digits.
2. Progressive shortening of digit, skin folds (telescopic finger)
How is psoriatic arthritis managed?
- Crossover between systemic treatment for psoriasis and arthritis (rheumatology and dermatology input).
- NSAIDs, DMARDs, anti-TNF medications, ustekinumab last-line.
