5-Minute Clinical Consult : Arthritis, Psoriatic

Arthritis, Psoriatic

Description

PsA is a seronegative spondyloarthropathy characterized by inflammatory arthritis and enthesitis.
5 patterns of arthritis in PsA include:
- Asymmetric oligoarthritis: Usually involves large joints
- Distal interphalangeal (DIP) joint predominant: Often associated with nail psoriasis
- Symmetric polyarthritis: May be indistinguishable from rheumatoid arthritis (RA)
- Spondyloarthritis: Asymmetric and discontinuous, unlike ankylosing spondylitis (AS)
- Arthritis mutilans: Destructive, resorptive arthritis; produces so-called opera-glass or telescoping digit
Although psoriasis generally is present, it may be limited in extent:
- Course of arthritis and extent of psoriasis do not appear to correlate.
- Other extra-articular features, such as iritis, are less common.
- Damaging joint disease may occur in 40–57%. Characteristic radiologic changes include joint erosions that begin marginally and move centrally (“pencil-in-cup deformity”) and periostitis.
Rheumatoid factor (RF) and cyclic citrullinated peptide (anti-CCP) antibody are usually negative. HLA-B27 may be positive.

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5-Minute Clinical Consult (5MCC) for Mobile + Web helps you diagnose, treat, and follow up on over 900 medical conditions. The 2013 edition also includes Diagnosaurus, 200 pediatrics topics, and medical RSS feeds.

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