Psoriatic arthritis definition, diagnosis and treatment

Here, we are going to discuss Psoriatic arthropathy regarding its definition,clinical subtypes, clinical picture (symptoms and signs), diagnostic investigations and treatment approaches .How to diagnose Psoriatic arthropathy ?

Here, we are going to discuss Psoriatic arthropathy (arthritis ) regarding its definition,clinical subtypes, clinical picture (symptoms and signs), diagnostic investigations and treatment approaches .
Definition
• It is an inflammatory arthritis that occurs in about 10 % of patients with psoriasis.
• It shares symptoms, signs and x-ray finding of spondyloarthritis.

How to diagnose Psoriatic arthropathy ?

Clinical picture  There are 5 clinical subtypes
1-Asymmetric oligoarthropathy:-
Psoriatic-arthritis
• There is asymmetric involvemment of both large and small joints
• There is a sausage finger or toe (dactylitis) due to interphalangeal joint synovitis, tensosynovitis and inflammation of the intervening tissues.
2- Symmetric polyarthropathy like rheumatoid disease.
3- Arthritis mutilans:-
• This is a severe destructive arthropathy of fingers and toes with periarticular osteolysis and bone shortening causing telescoping of digits i.e the encasing skin appears invaginated and telescoped.
4- Psoriatic spondylitis with sacroiliitis.

5- Psoriatic nail disease with distal interphalangeal joint involvement.
Investigations
• Rheumatoid factor is negative.
• Anaemia
• Hyperuricemia.
• Polyclonal hypergamma globulinemia.
• There is osteolysis of the metatarsal heads and central erosion of the proximal phalanges causing (pencil cup) appearance.
• Bone resorption giving opera-glass appearance. Also sacroiliitis and spondylitis may present.

Treatment of Psoriatic arthropathy 

• Rest, NSAIDs, local synovitis responds to intraarticular steroid injection.
• Gold and methotrexate are tried.
• Photochemotherapy and long wave U.V light for skin lesions.
• TNF blockers can be used in resistant cases.

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Med2Date: Psoriatic arthritis definition, diagnosis and treatment
Psoriatic arthritis definition, diagnosis and treatment
Here, we are going to discuss Psoriatic arthropathy regarding its definition,clinical subtypes, clinical picture (symptoms and signs), diagnostic investigations and treatment approaches .How to diagnose Psoriatic arthropathy ?
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