PSORIATIC ARTHRITIS Flashcards Preview

ORTHOPEDICS AND RHEUMATOLOGY > PSORIATIC ARTHRITIS > Flashcards

Flashcards in PSORIATIC ARTHRITIS Deck (27):
1

Define psoriatic arthritis.

Chronic autoimmune inflammatory arthritis associated with psoriasis.

2

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.

3

Is psoriasis infectious?

No.

4

What percentage of psoriasis sufferers develop arthritis?

8%

5

What are the different types of psoriatic arthritis?

Seronegative symmetrical polyarthritis
Asymmetric oligoarticular arthritis
Lone distal interphalangeal arthritis
Arthritis mutilans
Spondylitic pattern +/- sacroiliitis
Juvenile onset psoriatic arthritis

6

Which joints are most often affected in seronegative symmetrical polyarthritis?

Wrists
Ankles
Feet
Fingers

7

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

8

Which joints are most commonly affected by asymmetric oligoarticular arthritis?

Hands
Feet

9

How many joints, by definition, are affected by asymmetric oligoarticular arthritis?

Oligo -- 1-5 joints

10

Other than joint pain, what signs and symptoms might be present in someone with asymmetric oligoarticular arthritis?

Enthesopathy
Dactylitis
Nail dystrophy
Cutaneous lesions (psoriasis)
Interphalangeal joint synovitis
Tenosynovitis

11

Which joints are most affected by lone distal interphalangeal disease?

Distal interphalangeal joints

12

Are men or women more likely to develop lone distal interphalangeal disease?

Men

13

How is the affected nail and DIP described in someone with lone distal interphalangeal disease?

Hammer blow appearance

14

Which joints are most often affected in arthritis mutilans?

DIP
PIP

15

Other than joint pain, what other signs might be seen in the hand of someone with arthritis mutilans?

Telescoping

16

What causes telescoping in the fingers of patients with arthritis mutilans?

Periarticular osteolysis and bone shortening

17

What percentage of patients with psoriatic arthritis are affected by arthritis mutilans?

5%

18

Are men or women more likely to develop the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?

Men

19

What are the symptoms of the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?

Morning back stiffness
Movement limitation

20

What might be seen on the radiograph of someone with the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?

Syndesmophytes
Paravertebral ossification
Fusion of vertebral bodies
Calcified intervertebral discs

21

Are vertebrae affected symmetrically or asymmetrically in the spondylitic pattern (+/- sacroiliitis) of psoriatic arthritis?

Asymmetrically

22

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.

23

What are the CASPAR diagnostic criteria for diagnosing psoriatic arthritis?

Inflammatory articular disease plus 3 points worth of the following:

Psoriasis (2)
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)

24

What the pharmacological treatment options for patients with psoriatic arthritis?

DMARDs (Leflunomide, Sulfasalazine, Methotrexate)
NSAIDs
Steroid injections
Cytokine modulators (adalimumab, etanercept, golimumab and infliximab)

25

Why might oral steroids not be a good treatment option in someone with psoriatic arthritis?

Oral steroids may cause rebound exacerbations of skin lesions.

26

What group of diseases does psoriatic arthritis fall under?

Seronegative Spondyloarthropathies

27

What is the surface antigen associated with psoriatic arthritis?

HLA-B27