PsoriaticArthirits - week 6 PBL

Question 1

What is psoriatic arthritis?

Answer 1

A form of spondyloarthopy

Arthritis in association with psoriasis

Question 2

Presentation of psoriatic arthritis?

Answer 2

Asymmetric oligoarthritis (wrist, DIP only, ankle)
Often psoriasis present before joint pain but not always
30% of people with psoriasis develops PSA
Lower back pain and sacroiliitis

Question 3

What nail and hand changes can occur in psoriatic arthritis?

Answer 3

Pitting of the nail
Oncholysis
Dactylitis
Enthesitis
Psoriatic plaques

Question 4

X ray features of psoriatic arthritis?

Answer 4

Pencil in cup appearance
Erosions on DIP
Fusion of DIP and PIP through syndesphophytes

Question 5

What serious bone phalanx destruction can occur in psoriatic arthritis?

Answer 5

Arthritis mutilans

Question 6

What extra articular manifestations can occur in psoriatic arthritis?

Answer 6

Plantar fasciitis - most common
Achilles tendonitis
Nail pitting, onycholysis
Psoriasis on extensor surfaces

Question 7

Management for psoriatic arthritis?

Answer 7

NSAIDs for pain
DMARDS (methotrexate, lefkunimide, sulfasalazine)
ANTI - TNF (etanercept, infliximab, adalimumab)

Ustekinumab - last line monoclonal antibody targeting IL 12 and 23