Psoriatic arthritis: Difference between revisions

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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
==Overview==


==Historical Perspective==
{{Psoriatic arthritis}}
*[Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
{{CMG}}; {{AE}} {{CK}}
*In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
*In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].
==Classification==
*[Disease name] may be classified according to [classification method] into [number] subtypes/groups:
:*[group1]
:*[group2]
:*[group3]
*Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].
==Pathophysiology==
*The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
*The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
*On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
==Clinical Features== 


==Differentiating [disease name] from other Diseases==
==[[Psoriatic arthritis overview|Overview]]==
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
:*[Differential dx1]
:*[Differential dx2]
:*[Differential dx3]
==Epidemiology and Demographics==
* The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
* In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
===Age===
*Patients of all age groups may develop [disease name].
*[Disease name] is more commonly observed among patients aged [age range] years old.
*[Disease name] is more commonly observed among [elderly patients/young patients/children].
===Gender===
*[Disease name] affects men and women equally.
*[Gender 1] are more commonly affected with [disease name] than [gender 2].
* The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
===Race===
*There is no racial predilection for [disease name].
*[Disease name] usually affects individuals of the [race 1] race.
*[Race 2] individuals are less likely to develop [disease name].
==Risk Factors==
*Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
== Natural History, Complications and Prognosis==
*The majority of patients with [disease name] remain asymptomatic for [duration/years].
*Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
*If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
*Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
*Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].
== Diagnosis ==
===Diagnostic Criteria===
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
:*[criterion 1]
:*[criterion 2]
:*[criterion 3]
:*[criterion 4]
=== Symptoms ===
*[Disease name] is usually asymptomatic.
*Symptoms of [disease name] may include the following:
:*[symptom 1]
:*[symptom 2]
:*[symptom 3]
:*[symptom 4]
:*[symptom 5]
:*[symptom 6]
=== Physical Examination ===
*Patients with [disease name] usually appear [general appearance].
*Physical examination may be remarkable for:
:*[finding 1]
:*[finding 2]
:*[finding 3]
:*[finding 4]
:*[finding 5]
:*[finding 6]
=== Laboratory Findings ===
*There are no specific [[Medical laboratory|laboratory]] findings associated with [[Psoriatic arthritis (patient information)|psoriatic arthritis]] and most the tests are non-specific.
*However, there are certain [[Medical laboratory|laboratory]] tests that can check for markers of [[inflammation]] and to exclude other [[Disease|diseases]]. These include:<ref name="pmid17828345">{{cite journal |vauthors=Punzi L, Podswiadek M, Oliviero F, Lonigro A, Modesti V, Ramonda R, Todesco S |title=Laboratory findings in psoriatic arthritis |journal=Reumatismo |volume=59 Suppl 1 |issue= |pages=52–5 |date=2007 |pmid=17828345 |doi= |url=}}</ref>
** [[Complete blood count|CBC]] with differential count
*** [[Leukocytosis]]
*** [[Anemia|Anaemia]]
** Elevated [[Erythrocyte sedimentation rate|ESR]]
** Elevated [[C-reactive protein|CRP]] (C- reactive protein)
** [[Autoantibody|Autoantibodies]]: The following [[Autoantibody|autoantibodies]] may be found in patients with [[Psoriatic arthritis (patient information)|psoriatic arthritis]].<ref name="pmid15834057">{{cite journal |vauthors=Johnson SR, Schentag CT, Gladman DD |title=Autoantibodies in biological agent naive patients with psoriatic arthritis |journal=Ann. Rheum. Dis. |volume=64 |issue=5 |pages=770–2 |date=May 2005 |pmid=15834057 |pmc=1755477 |doi=10.1136/ard.2004.031286 |url=}}</ref>
*** [[Rheumatoid factor]]
*** [[Antinuclear antibodies|ANA]] ([[Antinuclear antibodies]])
*** Anti-citrullinated peptide antibodies (ACPA)
** Genetic markers:<ref name="pmid23916976">{{cite journal |vauthors=Chandran V, Bull SB, Pellett FJ, Ayearst R, Rahman P, Gladman DD |title=Human leukocyte antigen alleles and susceptibility to psoriatic arthritis |journal=Hum. Immunol. |volume=74 |issue=10 |pages=1333–8 |date=October 2013 |pmid=23916976 |doi=10.1016/j.humimm.2013.07.014 |url=}}</ref><ref name="pmid21900282">{{cite journal |vauthors=Eder L, Chandran V, Pellet F, Shanmugarajah S, Rosen CF, Bull SB, Gladman DD |title=Human leucocyte antigen risk alleles for psoriatic arthritis among patients with psoriasis |journal=Ann. Rheum. Dis. |volume=71 |issue=1 |pages=50–5 |date=January 2012 |pmid=21900282 |doi=10.1136/ard.2011.155044 |url=}}</ref>
*** [[HLA-B27]]
*** [[HLA-C]]*06
** [[Synovial fluid]] analysis: Elevated [[White blood cells|WBC]] count suggestive of [[inflammation]].


===Imaging Findings===
==[[Psoriatic arthritis historical perspective|Historical Perspective]]==
* X-Ray of digits:<ref name="pmid25231177">{{cite journal |vauthors=McGonagle D, Hermann KG, Tan AL |title=Differentiation between osteoarthritis and psoriatic arthritis: implications for pathogenesis and treatment in the biologic therapy era |journal=Rheumatology (Oxford) |volume=54 |issue=1 |pages=29–38 |date=January 2015 |pmid=25231177 |pmc=4269795 |doi=10.1093/rheumatology/keu328 |url=}}</ref>
** Subchondral cyst and erosions
** Fluffy periostitis
** Ankylosis
** Phalangeal tuft acroosteolysis
** New bone formation: Perisoteal and endosteal bone formation may result in increased  bone density of an entire phalanx resulting in so called ivory phalanx.
** Pencil-in-cup deformity (osteolytic lesions) usually involving DIP joints but also affects PIP joints
** Osteolysis and ankylosis both coexists in the same joints of hands and foot
** Enthesitis
** Dactylitis
** Gross finger deformity


=== Other Diagnostic Studies ===
==[[Psoriatic arthritis classification|Classification]]==
*[Disease name] may also be diagnosed using [diagnostic study name].
*Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
== Treatment ==
=== Medical Therapy ===
*There is no treatment for [disease name]; the mainstay of therapy is supportive care.
*The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
*[Medical therapy 1] acts by [mechanism of action 1].
*Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
=== Surgery ===
*Surgery is the mainstay of therapy for [disease name].
*[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
*[Surgical procedure] can only be performed for patients with [disease stage] [disease name].
=== Prevention ===
*There are no primary preventive measures available for [disease name].
*Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].


*Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
==[[Psoriatic arthritis pathophysiology|Pathophysiology]]==
==References==
{{Reflist|2}}
[[Category:Pick One of 28 Approved]]


==[[Psoriatic arthritis causes|Causes]]==
==[[Psoriatic arthritis differential diagnosis|Differentiating Psoriatic arthritis from Other Diseases]]==
==[[Psoriatic arthritis epidemiology and demographics|Epidemiology and Demographics]]==
==[[Psoriatic arthritis risk factors|Risk Factors]]==
==[[Psoriatic arthritis screening|Screening]]==
==[[Psoriatic arthritis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==Diagnosis==
[[Psoriatic arthritis diagnostic study of choice |Diagnostic study of choice]] | [[Psoriatic arthritis history and symptoms|History and Symptoms]] | [[Psoriatic arthritis physical examination|Physical Examination]] | [[Psoriatic arthritis laboratory tests|Laboratory Findings]] | [[Psoriatic arthritis electrocardiogram|Electrocardiogram]] | [[Rheumatoid arthritis x ray|X ray]] | [[Rheumatoid arthritis echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Psoriatic arthritis CT|CT]] | [[Psoriatic arthritis MRI|MRI Findings]] | [[Psoriatic arthritis other imaging findings|Other Imaging Findings]] | [[Psoriatic arthritis other diagnostic studies|Other Diagnostic Studies]]
==Treatment==
[[Psoriatic arthritis medical therapy|Medical Therapy]] |  [[Psoriatic arthritis surgical therapy|Surgical Therapy]]  |  [[Psoriatic arthritis Primary prevention|Primary prevention]] | [[Psoriatic arthritis secondary prevention|Secondary prevention]] | [[Psoriatic arthritis future or investigational therapies|Future or Investigational Therapies]]
==Case Studies==
:[[Psoriatic arthritis case study 1|Case #1]]
==Related Chapters==
{{Diseases of the musculoskeletal system and connective tissue}}
{{WH}}
{{WS}}
{{WS}}
{{WH}}
e)|adverse effects]] and associated [[Comorbidity|comorbid conditions]].
 
[[Category:Arthritis]]
[[Category:Autoimmune diseases]]
[[Category:Rheumatology]]

Latest revision as of 23:52, 29 July 2020


For patient information click here

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Overview

Historical Perspective

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Pathophysiology

Causes

Differentiating Psoriatic arthritis from other Diseases

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Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography and Ultrasound

CT

MRI

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Psoriatic arthritis from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X ray | Echocardiography and Ultrasound | CT | MRI Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgical Therapy | Primary prevention | Secondary prevention | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

Template:Diseases of the musculoskeletal system and connective tissue Template:WH Template:WS e)|adverse effects]] and associated comorbid conditions.