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9 Cards in this Set
- Front
- Back
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How many people who have psoriasis have associated arthritis?
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20%
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Does skin psoriasis usually occur before psoriatic joint arthritis?
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Skin occurs first in 75%
Simultaneous onset 15% Onset joints before skin 10% |
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What are the different types of psoriatic arthritis?
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Distal interphalangeal joint
Oligoarthritis (< 4) - commonest - usually larger jts Polyarthritis (> 5) - asymmetry and involved of DIP distinguishes it from RA Arthritis mutilans - severe jt destruction and osteolysis Spondylitis and sacroilitis (5% alone 40% in association with peripheral arthritis) |
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What dermatolical manifestations are seen in psoriatic arthritis?
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Well-demarcated erythematous plaques with silvery scale
Nail involvement Pitting, Transverse or longitudinal ridging, Oncholysis (lifting of the nail bed) Discolouration Subungual hyperkeratosis Oil drops |
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What special articular features are seen in psoriatic arthritis?
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Dactilytis (30-40%)
Profuse diffuse swelling of digit Due to flexor tenosynovitis Enthesitis (20-40%) Inflammation at site of insertion of tendons Achillies, lateral epicondylitis |
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What extra-articular features are seen in psoriatic arthritis?
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conjunctivitis
Iritis (uveitis) aortic insufficiency apical lung fibrosis cauda equina syndrome |
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What investigations are usually done in psoriatic arthritis?
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FBC - Anaemia of chronic disease, WCC usually N
CRP/ESR - N or raised Rh F - negative X-ray - usually normal early in disease with characteristic changes in late disease |
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What are the radiological features of psoriatic arthritis?
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Floating syndesmophytes
pencil and cup appearance at IP joints osteolysis, periostitis |
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Management of psoriatic arthritis?
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NSAIDs
Intra-articular steroids May require disease modifying agents if there is loss of joint function (methotrexate, salozypryin, TNF alpha) Synovectomy - medical or surgical Spondylitis - physiotherapy and exericse |
