小结
定义
病史和体格检查
关键诊断因素
- 个人或家族银屑病史
- 关节疼痛和僵硬
- 外周关节炎
- 指趾炎
- 既往有头皮或指/趾甲问题
其他诊断因素
- 附着点炎
- 脊椎僵硬
- 颈椎活动能力降低
- 葡萄膜炎
- 炎症性肠病
危险因素
- 银屑病
- 银屑病或银屑病性关节炎家族史
- 关节或肌腱创伤史
- 感染
- 吸烟
诊断性检查
首要检查
- 手足X片
- 红细胞沉降率（ESR）和 C 反应蛋白（CRP）
- 类风湿因子
- 抗环瓜氨酸肽（抗 CCP）抗体
- 血脂检查
- 空腹血糖
- 尿酸水平
- 滑液抽吸分析
需考虑的检查
- 脊椎和骨盆X片
- 骶髂关节的 MRI 扫描
新兴检查
- 关节超声
治疗流程
外周关节炎
中轴性疾病
附着点炎
指趾炎
撰稿人
作者
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
利益声明
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.
鸣谢
Dr Siba P. Raychaudhuri would like to gratefully acknowledge Dr Clement J. Michet, previous contributor to this topic.
利益声明
CJM is an author of a reference cited in this topic.
同行评议者
Philip S. Helliwell, MD, PhD
Senior Lecturer in Rheumatology
University of Leeds
Leeds
UK
利益声明
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
利益声明
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
利益声明
WJT is an author of some references cited in this topic.
鉴别诊断
- 类风湿性关节炎 (RA)
- 痛风
- 糜烂性骨关节炎
更多 鉴别诊断指南
- 2022 美国风湿病学会风湿病和肌肉骨骼疾病患者疫苗接种指南
- EULAR 关于炎症性风湿病和肌肉骨骼疾病生物药品治疗药物监测的考虑要点
更多 指南患者教育信息
痛风
银屑病
更多 患者教育信息
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明