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Psoriatic arthritis

Last reviewed: 18 Sep 2025
Last updated: 28 Jul 2023

Summary

Definition

History and exam

Key diagnostic factors

  • personal or family history of psoriasis
  • joint pain and stiffness
  • peripheral arthritis
  • dactylitis
  • history of scalp or nail problems
Full details

Other diagnostic factors

  • enthesitis
  • spinal stiffness
  • reduction of cervical spine mobility
  • uveitis
  • inflammatory bowel disease
Full details

Risk factors

  • psoriasis
  • family history of psoriasis or psoriatic arthritis
  • history of joint or tendon trauma
  • infection
  • smoking
Full details

Diagnostic investigations

1st investigations to order

  • plain film radiographs of the hands and feet
  • erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)
  • rheumatoid factor
  • anti-cyclic citrullinated peptide (anti-CCP) antibody
  • lipid profile
  • fasting blood glucose
  • uric acid level
  • synovial fluid aspiration and analysis
Full details

Investigations to consider

  • plain film radiographs of the spine and pelvis
  • MRI scan of sacroiliac joints
Full details

Emerging tests

  • joint ultrasound

Treatment algorithm

ACUTE

peripheral arthritis

axial disease

enthesitis

dactylitis

Contributors

Authors

Siba P. Raychaudhuri, MD, FACP, FACR

Professor

Director, Department of Medicine/ Rheumatology, Allergy, and Clinical Immunology

University of California Davis School of Medicine

Sacramento

CA

Disclosures

SPR declares that he has received research grants, prepared research papers, and attended board meetings for Sun Pharmacy, AbbVie Pharmacy, Novartis Pharma, Johnson and Johnson, the National Psoriasis Foundation, and the US National Institutes of Health (NIH). SPR is the author of some of the references cited in this topic.

Acknowledgements

Dr Siba P. Raychaudhuri would like to gratefully acknowledge Dr Clement J. Michet, previous contributor to this topic.

Disclosures

CJM is an author of a reference cited in this topic.

Peer reviewers

Philip S. Helliwell, MD, PhD

Senior Lecturer in Rheumatology

University of Leeds

Leeds

UK

Declarações

PSH is an author of some references cited in this topic.

Luis R. Espinoza, MD

Professor and Chief

Section of Rheumatology

Department of Internal Medicine

LSU Health Sciences Center

New Orleans

LA

Declarações

LRE declares that he has no competing interests.

William J. Taylor, PhD, MBChB, FAFRM, FRACP

Associate Professor

Department of Medicine

University of Otago, Wellington

Wellington

New Zealand

Declarações

WJT is an author of some references cited in this topic.

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Referências

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Principais artigos

Singh JA, Guyatt G, Ogdie A, et al. 2018 American College of Rheumatology/National Psoriasis Foundation guideline for the treatment of psoriatic arthritis. Arthritis Rheumatol. 2019 Jan;71(1):5-32.Texto completo  Resumo

Gossec L, Baraliakos X, Kerschbaumer A, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis. 2020 Jun;79(6):700-12.Texto completo  Resumo

Coates LC, Soriano ER, Corp N, et al; GRAPPA Treatment Recommendations domain subcommittees. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021. Nat Rev Rheumatol. 2022 Aug;18(8):465-79.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Psoriatic arthritis images
  • Diagnósticos diferenciais

    • Rheumatoid arthritis (RA)
    • Gout
    • Erosive osteoarthritis
    Mais Diagnósticos diferenciais
  • Diretrizes

    • 2022 American College of Rheumatology guideline for vaccinations in patients with rheumatic and musculoskeletal diseases
    • EULAR points to consider for therapeutic drug monitoring of biopharmaceuticals in inflammatory rheumatic and musculoskeletal diseases
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Gout

    Psoriasis: what is it?

    Mais Folhetos informativos para os pacientes
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