Summary
Definition
History and exam
Key diagnostic factors
- personal or family history of psoriasis
- joint pain and stiffness
- peripheral arthritis
- dactylitis
- hx of scalp or nail problems
Other diagnostic factors
- pain at site of tendon attachment
- spinal stiffness
- reduction of cervical spine mobility
Risk factors
- psoriasis
- FHx of psoriasis or psoriatic arthritis
- hx of joint or tendon trauma
- HIV infection
Diagnostic investigations
1st investigations to order
- plain film x-rays of the hands and feet
- erythrocyte sedimentation rate and C-reactive protein
- rheumatoid factor
- anticyclic citrullinated peptide antibody
- lipid profile
- fasting blood glucose
- uric acid level
- synovial fluid aspiration and analysis
Investigations to consider
- plain film x-rays of the spine and pelvis
- MRI scan of sacroiliac joints
Emerging tests
- joint ultrasound
Treatment algorithm
limited peripheral joint disease
progressive peripheral joint disease
dactylitis
spondylitis and/or enthesitis
Contributors
Authors
Clement J. Michet, MD
Consultant Rheumatologist
Mayo Clinic
Rochester
MN
Disclosures
CJM is an author of a reference cited in this monograph.
Peer reviewers
Philip S. Helliwell, MD, PhD
Senior Lecturer in Rheumatology
University of Leeds
Leeds
UK
Disclosures
PSH is an author of some references cited in this monograph.
Luis R. Espinoza, MD
Professor and Chief
Section of Rheumatology
Department of Internal Medicine
LSU Health Sciences Center
New Orleans
LA
Disclosures
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
Disclosures
WJT is an author of some references cited in this monograph.
Differentials
- Rheumatoid arthritis (RA)
- Gout
- Erosive osteoarthritis
More DifferentialsGuidelines
- Apremilast for treating active psoriatic arthritis
- Assessing, managing and monitoring biologic therapies for inflammatory arthritis (3rd edition)
More GuidelinesPatient leaflets
Gout
Psoriasis
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