Psoriatic arthritis: Difference between revisions

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{{CMG}}; {{AE}}{{CK}}{{MJ}}
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


==Overview==
{{Psoriatic arthritis}}
Psoriatic arthritis is a [[systemic]], immune- mediated inflammatory [[arthritis]], associated with [[psoriasis]]. The [[etiology]] is not clearly understood. It may be caused by complex interaction between [[Genetics|genetic]], [[Immune system|immunologic]] and environmental mechanisms which act as triggers for the [[disease]] development. Both psoriatic arthritis and [[psoriasis]] have been shown  to have strong familial predisposition.  Psoriatic arthritis present with [[pain]] and stiffness in the affected [[Joint|joints.]] According to Moll and Wright criteria, [[joint]] involvement pattern in psoriatic arthritis include distal [[arthritis]] usually involving distal interphalangeal joints, asymmetric [[oligoarthritis]], symmetric [[polyarthritis]], arthritis mutilans, [[spondylitis]], and [[sacroiliitis]]. Other [[Symptom|symptoms]] include [[Enthesopathy|enthesitis]] ([[pain]] and [[tenderness]] at the insertion of [[Tendon|tendons]] and [[Ligament|ligaments]] to the [[bone]]), [[dactylitis]] ( sausage like [[finger]] or [[toe]] swelling), [[Psoriasis|psoriatic skin plaques]], [[Nail (anatomy)|nail]] changes (pitting, [[hyperkeratosis]], and [[Nail (anatomy)|nail]] destruction). The [[pathophysiology]] of psoriatic arthritis consists of interactions between [[Cytokine|cytokines]], [[Dendritic cell|dendritic cells]], and [[T lymphocytes]]. Psoriatic arthritis must be differntiated from other inflammatory arthritides including [[rheumatoid arthritis]], [[ankylosing spondylitis]], [[reactive arthritis]], [[gout]], [[Chondrocalcinosis|pseudogout]], [[osteoarthritis]], [[arthritis]] associated with [[inflammatory bowel disease]]. The [[prevalence]] of [[Psoriatic arthritis (patient information)|psoriatic arthritis]] in general population ranges from 60 - 250 cases per 100,000 individuals and the [[prevalence]] of psoriatic arthritis among [[psoriasis]] patients is 11,000 per 100,000 individuals. The mainstay of therapy for psoriatic arthritis [[Non-steroidal anti-inflammatory drug|NSAIDs]],  conventional [[Disease-modifying antirheumatic drug|DMARDs]] (eg, [[methotrexate]], [[sulfasalazine]], [[cyclosporine]]) and biologic [[Disease-modifying antirheumatic drug|DMARDs]] (eg, [[TNF inhibitor|TNF inhibitors]]),  anti IL therapy (eg,  secukinumab, ustekinumab). Other treatment options include physiotherapy, patient education about disease and joint preservation and surgery. Psoriatic arthritis is associated with a number of [[Comorbidity|comorbid]] conditions due to circulating [[Antibody|immunoglobulins]], [[antibodies]] including [[metabolic syndrome]], increased [[insulin]] resistance, [[atherosclerosis]], [[stroke]], [[hypertension]], [[uveitis]], [[osteoporosis]] and [[depression]]. Patients are monitored regularly for [[disease]] activity, [[:Category:Drugs|drug]] efficacy, [[Adverse effect (medicine)|adverse effects]] and associated [[Comorbidity|comorbid conditions]].
{{CMG}}; {{AE}} {{CK}}
 
==[[Psoriatic arthritis overview|Overview]]==
 
==[[Psoriatic arthritis historical perspective|Historical Perspective]]==
 
==[[Psoriatic arthritis classification|Classification]]==
 
==[[Psoriatic arthritis pathophysiology|Pathophysiology]]==
 
==[[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}}
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

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Diagnosis

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X Ray

Echocardiography and Ultrasound

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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.