Flashcards in PSORIATIC ARTHRITIS Deck (27)
Define psoriatic arthritis.
Chronic autoimmune inflammatory arthritis associated with psoriasis.
What is psoriasis?
Psoriasis is a common condition where there is inflammation of the skin. It typically develops as patches (plaques) of red, scaly skin. Once you develop psoriasis it tends to come and go throughout life.
Is psoriasis infectious?
What percentage of psoriasis sufferers develop arthritis?
What are the different types of psoriatic arthritis?
Seronegative symmetrical polyarthritis
Asymmetric oligoarticular arthritis
Lone distal interphalangeal arthritis
Spondylitic pattern +/- sacroiliitis
Juvenile onset psoriatic arthritis
Which joints are most often affected in seronegative symmetrical polyarthritis?
On examination, how might you differentiate seronegative symmetrical polyarthritis from rheumatoid arthritis?
The DIP joints are often involved rather than the MCP joints
No skin nodules
Which joints are most commonly affected by asymmetric oligoarticular arthritis?
How many joints, by definition, are affected by asymmetric oligoarticular arthritis?
Oligo -- 1-5 joints
Other than joint pain, what signs and symptoms might be present in someone with asymmetric oligoarticular arthritis?
Cutaneous lesions (psoriasis)
Interphalangeal joint synovitis
Which joints are most affected by lone distal interphalangeal disease?
Distal interphalangeal joints
Are men or women more likely to develop lone distal interphalangeal disease?
How is the affected nail and DIP described in someone with lone distal interphalangeal disease?
Hammer blow appearance
Which joints are most often affected in arthritis mutilans?
Other than joint pain, what other signs might be seen in the hand of someone with arthritis mutilans?
What causes telescoping in the fingers of patients with arthritis mutilans?
Periarticular osteolysis and bone shortening
What percentage of patients with psoriatic arthritis are affected by arthritis mutilans?
Are men or women more likely to develop the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?
What are the symptoms of the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?
Morning back stiffness
What might be seen on the radiograph of someone with the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?
Fusion of vertebral bodies
Calcified intervertebral discs
Are vertebrae affected symmetrically or asymmetrically in the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?
From a radiograph, how might you diagnose the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis instead of ankylosing spondylitis?
In ankylosing spondylitis, vertebrae are normally affected symmetrical. This is not the case in the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis.
What are the CASPAR diagnostic criteria for diagnosing psoriatic arthritis?
Inflammatory articular disease plus 3 points worth of the following:
History of psoriasis (1)
Family history of psoriasis (1)
Psoriatic nail dystrophy (1)
Negative RF (1)
Current dactylitis (1)
History of dactylitis (1)
Jaxta-artciular new bone (1)
What the pharmacological treatment options for patients with psoriatic arthritis?
DMARDs (Leflunomide, Sulfasalazine, Methotrexate)
Cytokine modulators (adalimumab, etanercept, golimumab and infliximab)
Why might oral steroids not be a good treatment option in someone with psoriatic arthritis?
Oral steroids may cause rebound exacerbations of skin lesions.
What group of diseases does psoriatic arthritis fall under?