PSORIATIC ARTHRITIS

PSORIATIC ARTHRITIS


PSORIATIC ARTHRITIS

  • Form of arthritis that affects some people who have psoriasis.
  • Psoriasis — a condition that features red patches of skin topped with silvery scales.
  • Joint pain, stiffness and swelling are the main symptoms of psoriatic arthritis.
  • Can affect any part of body, including fingertips and spine, range from relatively mild to severe.
  • No cure for psoriatic arthritis exists. 

SYMPTOMS:

  • Both psoriatic arthritis and psoriasis are chronic diseases that get worse over time.
  • Psoriatic arthritis can affect joints on just one side or on both sides of body.
  • The signs and symptoms of psoriatic arthritis often resemble those of rheumatoid arthritis.
  • Both diseases cause joints to become painful, swollen and warm to the touch.
  • Psoriatic arthritis is more likely to also cause:
  1. Swollen fingers and toes
  2. Foot pain
  3. Lower back pain

Causes

  • Psoriatic arthritis occurs when body’s immune system begins to attack healthy cells & tissue.
  • The abnormal immune response causes inflammation in joints as well as overproduction of skin cells.
  • Physical trauma or viral or bacterial infection, may trigger psoriatic arthritis in people with an inherited tendency.

 Diagnosis

  1. Closely examine joints for signs of swelling or tenderness
  2. Check fingernails for pitting, flaking and other abnormalities
  3. Press on the soles of feet and around heels to find tender areas.
  •  No single test can confirm a diagnosis of psoriatic arthritis.

Imaging tests

X-rays:

  • Pinpoint changes in the joints that occur in psoriatic arthritis but not in other arthritic conditions.

Magnetic resonance imaging (MRI):

  • Used to check for problems with the tendons and ligaments in your feet and lower back.

Laboratory tests

  1. Rheumatoid factor (RF)
  2. Joint fluid test

Treatment

  • No cure exists for psoriatic arthritis.
  • Treatment focuses on controlling inflammation in affected joints to prevent joint pain and disability.

Medications

  • Drugs used to treat psoriatic arthritis include:

  1. NSAIDs.

  2. Disease-modifying antirheumatic drugs (DMARDs)

  • Slow the progression of psoriatic arthritis and save the joints and other tissues from permanent damage.
  • Common DMARDs include methotrexate (Trexall), leflunomide (Arava), and sulfasalazine (Azulfidine).

  3. Immunosuppressants

  4. TNF-alpha inhibitors

  5. Newer medications

  • E.g. include apremilast (Otezla), ustekinumab (Stelara) and secukinumab (Cosentyx).

Surgical and other procedures

  1. Steroid injections.
  2. Joint replacement surgery.

Exam Important

  • Pencil in cup deformity is seen in Psoriatic arthritis.
  • Joint pain, stiffness and swelling are the main symptoms of psoriatic arthritis.
  • CASPAR criteria is used in diagnosis of Psoriatic arthritis.
  • Seronegative arthritis include  Ankylosing spondylitis, Reiters arthritis & Psoriatic arthritis.
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