Approach

The diagnosis of psoriatic arthritis is made clinically based on history and physical examination. Laboratory and radiological investigations are obtained either to stage the severity of the disease or to exclude other diagnoses. Recognition of inflammatory joint symptoms is the essential first step. In a patient with psoriasis, prolonged morning stiffness in joints (lasting >30 minutes), morning first-step foot pain, and joint or digit swelling strongly suggest psoriatic arthritis. These symptoms may be similar to those of early rheumatoid arthritis (RA). The 2 arthropathies can often be distinguished clinically by the pattern of joint involvement. com.bmj.content.model.Caption@114f962[Figure caption and citation for the preceding image starts]: Psoriatic arthritisFrom the collection of Dr Tsu-Yi Chuang; used with permission [Citation ends].

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