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Psoriatic Arthritis

 Syn. PsA

Signs & Symptoms

 Psoriasis #criteria
Ref: Uptodate [ Clinical manifestations and diagnosis of psoriatic arthritis] Harrison [ 2571] Epocrates [ Risk Factors]
Nail bed hyperkeratosis
Ref: Uptodate [ Clinical manifestations and diagnosis of psoriatic arthritis] Harrison [ 2571]
Wheezing (negative symptom)
Ref: Epocrates [ Differential Diagnosis]
Joint pain recurrence with prolonged rest
Note: Improvement with use, and recurrence with prolonged rest, due to Inflammatory joint pain
Ref: Uptodate [ Clinical manifestations and diagnosis of psoriatic arthritis] Harrison [ 2571] Epocrates [ History & Exam]

Physical Examination

 Tenderness of individual joints
Note: due to Synovitis, due to peripheral arthritis
Ref: Epocrates [ https://online.epocrates.com/diseases/524/Psoriatic-arthritis]
Swelling of individual joints
Note: due to Synovitis, due to peripheral arthritis
Ref: Epocrates [ https://online.epocrates.com/diseases/524/Psoriatic-arthritis]
Lumbar spine stiffness
Ref: Epocrates [ History & Exam]

Lab / Serology

 Low titer of ANA
Note: ≤1/40
Ref: Uptodate [ Clinical manifestations and diagnosis of psoriatic arthritis]
Positive rheumatoid factor (negative symptom) #criteria
Ref: Uptodate [ Clinical manifestations and diagnosis of psoriatic arthritis] Epocrates [ Criteria]
High CRP
Ref: Harrison [ 2572] Epocrates [ Tests]

Imagin Study

 Pencil-in-cup deformity
Ref: Uptodate [ Clinical manifestations and diagnosis of psoriatic arthritis] Harrison [ 2571] Epocrates [ Tests]
Fluffy periostitis
Ref: Uptodate [ Clinical manifestations and diagnosis of psoriatic arthritis]
Gross destruction of isolated joints
Ref: Uptodate [ Clinical manifestations and diagnosis of psoriatic arthritis]

Complication

 Arthritis mutilans
Note: Widespread shortening of digits (“telescoping”)
Ref: Uptodate [ Clinical manifestations and diagnosis of psoriatic arthritis] Harrison [ 2571] Epocrates [ Tests]
Gross destruction of isolated joints
Ref: Uptodate [ Clinical manifestations and diagnosis of psoriatic arthritis]
Shortening of digits
Ref: Harrison [ 2571]

Risk Factors

Cause

Other