Psoriatic arthritis

Last reviewed: 26 Feb 2023
Last updated: 29 Mar 2018



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
More key diagnostic factors

Other diagnostic factors

  • pain at site of tendon attachment
  • spinal stiffness
  • reduction of cervical spine mobility
Other diagnostic factors

Risk factors

  • psoriasis
  • FHx of psoriasis or psoriatic arthritis
  • hx of joint or tendon trauma
  • HIV infection
More risk factors

Diagnostic investigations

1st investigations to order

  • plain film radiographs of the hands and feet
  • ESR and CRP
  • rheumatoid factor
  • anti-CCP antibody
  • lipid profile
  • fasting blood glucose
  • uric acid level
  • synovial fluid aspiration and analysis
More 1st investigations to order

Investigations to consider

  • plain film radiographs of the spine and pelvis
  • MRI scan of sacroiliac joints
More investigations to consider

Emerging tests

  • joint ultrasound

Treatment algorithm


limited peripheral joint disease

progressive peripheral joint disease


spondylitis and/or enthesitis



Clement J. Michet, MD

Consultant Rheumatologist

Mayo Clinic




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




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



LRE declares that he has no competing interests.

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

Associate Professor

Department of Medicine

University of Otago, Wellington


New Zealand


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

  • Psoriatic arthritis images
  • Differentials

    • Rheumatoid arthritis (RA)
    • Gout
    • Erosive osteoarthritis
    More Differentials
  • Guidelines

    • EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/16 update
    • European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update
    More Guidelines
  • Patient leaflets


    Psoriasis: what is it?

    More Patient leaflets
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