![]() Ivory phalanx: classically involving the distal phalanx of the great toe Periostitis: may appear as a periosteal layer of new bone, or as irregular thickening of the cortex itself 2ĭactylitis: which can present as a “ sausage digit” which refers to soft tissue swelling of a whole digit ultrasound examination of a sausage digit demonstrates underlying synovitis and tenosynovitis 4Īrthritis mutilans: osteolysis and articular collapse can cause a phenomenon referred to as "telescoping fingers" Joint subluxation or interphalangeal ankylosis may be present In the hands and feet, the pattern of distribution may be that of a symmetric polyarthropathy, or asymmetric oligoarthropathy, with a distal predominance.Įnthesitis and marginal bone erosions " pencil-in-cup" deformities are common, but not pathognomonic for PsA 3īone proliferation results in an irregular, “fuzzy” appearance to the bone around the affected joint 2 Knees, elbows, ankles, and shoulders are less frequently involved 2. It can also affect sacroiliac joints and spine. The disease most commonly involves the hands, followed by feet. The hallmark of psoriatic arthritis is the combination of erosive change with bone proliferation, in a predominantly distal distribution (e.g. interphalangeal more than metacarpophalangeal joints). Symmetric polyarthritis (similar in appearance to RA)ĭistal interphalangeal arthritis of the hands and feet One of the classification systems is the one by Moll and Wright, which classifies psoriatic arthritis into five subtypes 7: Urogenital: urethritis, prostatitis, balanitis, cervicitis, vaginitis ![]() Gastrointestinal: inflammatory bowel diseaseĬardiac: rhythm disturbances (e.g. Up to 60% are HLA-B27 positive 2. A proportion of patients have serum rheumatoid factor 6.Įxtra-articular manifestations are common 11: Pathologyīoth environmental and genetic factors are thought to play a role. It most commonly presents as an asymmetrical oligoarthritis with spondylitis common oligoarthritis may progress to polyarthritis in the clinical course of the disease 10,11. There is a strong association with nail involvement, particularly for distal interphalangeal joint arthritis. Psoriatic arthritis is associated with 11:ĭermatological features of psoriasis precede arthritis in ~65% (range 60-70%) whereas arthritic symptoms proceed dermatological features in 15-20% 11. ![]() The median age of diagnosis is 48 years 11. In contrast to many other arthropathies, there is no gender predilection in psoriatic arthritis. Overall prevalence is ~0.5% (range 0.1-1%), however, it affects up to ~25% (range 6-41%) of patients with psoriasis 1,11. ![]()
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