Psoriatic arthritis physical examination: Difference between revisions
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(Created page with "__NOTOC__ {{Psoriatic arthritis}} {{CMG}}; {{AE}} {{CK}} ==Overview== == Physical Examination = File:Psoriatic arthritis of feet.jpg|centre|thumb|Joint deformity and nail c...") |
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[[File:Psoriatic arthritis of feet.jpg|centre|thumb|Joint deformity and nail changes in psoriatic arthritis|Image by - By James Heilman, MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=9445021]] | [[File:Psoriatic arthritis of feet.jpg|centre|thumb|Joint deformity and nail changes in psoriatic arthritis|Image by - By James Heilman, MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=9445021]] | ||
*[[Patient|Patients]] with [[Psoriatic arthritis (patient information)|psoriatic arthritis]] usually appear normal. | *[[Patient|Patients]] with [[Psoriatic arthritis (patient information)|psoriatic arthritis]] usually appear normal. | ||
Revision as of 17:40, 10 May 2018
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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
Physical Examination
- Patients with psoriatic arthritis usually appear normal.
- Physical examination of a patient with psoriatic arthritis may include:
- Joint involvement:[1][2]
- Joint tenderness
- Joint swelling may or may not be present
- Redness and warmth
- Patterns of joint involvement in psoriatic arthritis may include according to moll and wright :
- Distal arthritis: Involving mostly DIP joints, may be symmetric or asymmetric. It may involve multiple joints or only few joints.
- Asymmetric oligoarthritis: Most common pattern can be seen in psoriatic arthritis. It is characterized by asymmetric involvement of less than 5 small or large joints.
- Symmetric polyarthritis
- Arthritis mutilans: Resorption of phalanges, metatarsals and, metacarpals.
- Spondylitis
- Sacroiliitis
- Joint effusion
- Achilles tendinitis[3]
- Dactylitis: sausage digit due to swelling of the whole finger or toe.[4]
- Skin:[5][6]
- Psoriatic arthritis may occur after the onset of psoriasis in most of the patients. However, in some cases, arthritis precede psoriasis. The phenotypes of skin psoriasis that are associated with an increased risk of psoriatic arthritis are the lesions in the scalp, nail, intergluteal, and perianal regions.[7]
- Nails:[8][9]
- Nail pits
- Onycholysis
- Subungual hyperkeratosis
- Splinter hemorrhages
- Beau lines
- Leukonychia
- Oil drop patches
- Nail crumbling
- Nail destruction
- Involvement of eyes:[10][11]
- Edema of hands or feet: Swelling of hands and feet which is asymmetrical with pitting edema may be found in some cases.[12]
References
- ↑ Moll JM, Wright V (1973). "Psoriatic arthritis". Semin. Arthritis Rheum. 3 (1): 55–78. PMID 4581554.
- ↑ Scarpa R, Peluso R, Atteno M (2007). "Clinical presentation of psoriatic arthritis". Reumatismo. 59 Suppl 1: 49–51. PMID 17828344.
- ↑ De Simone C, Guerriero C, Giampetruzzi AR, Costantini M, Di Gregorio F, Amerio P, Giampietruzzi AR (August 2003). "Achilles tendinitis in psoriasis: clinical and sonographic findings". J. Am. Acad. Dermatol. 49 (2): 217–22. PMID 12894068.
- ↑ Brockbank JE, Stein M, Schentag CT, Gladman DD (February 2005). "Dactylitis in psoriatic arthritis: a marker for disease severity?". Ann. Rheum. Dis. 64 (2): 188–90. doi:10.1136/ard.2003.018184. PMC 1755375. PMID 15271771.
- ↑ Elkayam O, Ophir J, Yaron M, Caspi D (2000). "Psoriatic arthritis: interrelationships between skin and joint manifestations related to onset, course and distribution". Clin. Rheumatol. 19 (4): 301–5. PMID 10941813.
- ↑ Wright V, Roberts MC, Hill AG (1979). "Dermatological manifestations in psoriatic arthritis: a follow-up study". Acta Derm. Venereol. 59 (3): 235–40. PMID 87081.
- ↑ Wilson FC, Icen M, Crowson CS, McEvoy MT, Gabriel SE, Kremers HM (February 2009). "Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study". Arthritis Rheum. 61 (2): 233–9. doi:10.1002/art.24172. PMC 3061343. PMID 19177544.
- ↑ Sobolewski P, Walecka I, Dopytalska K (2017). "Nail involvement in psoriatic arthritis". Reumatologia. 55 (3): 131–135. doi:10.5114/reum.2017.68912. PMC 5534507. PMID 28769136.
- ↑ Lai TL, Pang HT, Cheuk YY, Yip ML (August 2016). "Psoriatic nail involvement and its relationship with distal interphalangeal joint disease". Clin. Rheumatol. 35 (8): 2031–2037. doi:10.1007/s10067-016-3319-5. PMID 27251673.
- ↑ Lambert JR, Wright V (August 1976). "Eye inflammation in psoriatic arthritis". Ann. Rheum. Dis. 35 (4): 354–6. PMC 1007395. PMID 970993.
- ↑ Abbouda A, Abicca I, Fabiani C, Scappatura N, Peña-García P, Scrivo R, Priori R, Paroli MP (2017). "Psoriasis and Psoriatic Arthritis-Related Uveitis: Different Ophthalmological Manifestations and Ocular Inflammation Features". Semin Ophthalmol. 32 (6): 715–720. doi:10.3109/08820538.2016.1170161. PMID 27419848.
- ↑ Cantini F, Salvarani C, Olivieri I, Macchioni L, Niccoli L, Padula A, Falcone C, Boiardi L, Bozza A, Barozzi L, Pavlica P (2001). "Distal extremity swelling with pitting edema in psoriatic arthritis: a case-control study". Clin. Exp. Rheumatol. 19 (3): 291–6. PMID 11407082.