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Pathology
A seronegative oligoarthritis found in patients with psoriasis, with characteristic differentiating features of distal joint involvement
Aetiology
Unknown, but genetic influences, environmental and immunologic factors are thought to contribute towards the development of the disease
Signs
Psoriatic rash on extensor surfaces, nail pitting, onycholysis, dactylitis, enthesitis
Symptoms
Joint pain, swelling and reduced range of movement
Investigations
Bloods: Raised ESR and CRP, Negative ANA and Rheumatoid Factor
Imaging: X-rays show asymmetrical erosive small joints changes in hands and
feet, ‘pencil in cup’ periosteal bone formation, asymmetric sacroiliitis
CT/MRI assess for periarticular involvement
Treatment
Medical: NSAIDs, DMARDs, Biological Therapy, Intra-articular injection of
enthesis or single inflamed joints with corticosteroids
Prognosis
Good prognosis if diagnosed early
Significant sequelae of decreased range of motion or chronic pain.
Key Facts
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Key Images
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Key References
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