PsA
- Created by: OJSleek
- Created on: 22-05-22 17:53
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- psoriatic arthritis
- def
- sero-negative spondyloarthropathy
- Manifestations
- asymmetric or oligo monoarticular arthritis
- dipj, pipj, mcpj
- arthritis mutilans
- symmetric polyathritis
- Epidemiology
- affects around 25% of patients with psorisis
- equally affects men and women
- genetics- HLAB27 found in 50% of pts
- S+S
- arthritic symptoms on hands
- dactylitis in hands
- sausage digits
- onychodystrophy
- nail pitting
- onycholysis
- arthritis mutillans
- opera glass hands
- excess skin from shortening of phalanx bones which become folded transversly if resorb into one another
- clinical examination
- look
- rashes with silvery plaques
- over extensor surfaces
- elbows
- knees
- typically precedes joint involvement
- over extensor surfaces
- rashes with silvery plaques
- look
- other tests
- imaging
- radiograph of hands
- distal phalanx acrolysis
- dipj pencil and cup deformity
- simultaneousdestruction of middle phalanx and expansion of bases of distal phalanx
- small joint erosions
- pipj, mcp, wrist
- fluffy periostitis which is caused by perioseo ossification, acro-osteolysis
- flail digits
- spine and axial disease
- sacral-iliitis
- syndesmophytes
- paraobtebral ossification
- destruction distal tebral
- radiograph of hands
- imaging
- T/T
- non-operative is similar to RA
- NSAIDs
- methotrexate
- sulfosalizine
- ciclosporin
- TNF-alpha inhibitors
- operative t/t
- when DMARDS t/t exhausted
- digital fusion vs resection arthroplasty
- indicated for advanced joint disease for psa
- osteotomy
- digital fusion vs resection arthroplasty
- when DMARDS t/t exhausted
- non-operative is similar to RA
- def
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