Psoriatic arthritis
小结
定义
病史和体格检查
关键诊断因素
- personal or family history of psoriasis
- joint pain and stiffness
- peripheral arthritis
- dactylitis
- history of scalp or nail problems
其他诊断因素
- enthesitis
- spinal stiffness
- reduction of cervical spine mobility
- uveitis
- inflammatory bowel disease
危险因素
- psoriasis
- family history of psoriasis or psoriatic arthritis
- history of joint or tendon trauma
- infection
- smoking
诊断性检查
首要检查
- plain film x-rays 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
需考虑的检查
- plain film x-rays of the spine and pelvis
- MRI scan of sacroiliac joints
新兴检查
- joint ultrasound
治疗流程
peripheral arthritis
axial disease
enthesitis
dactylitis
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
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.全文 摘要
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.全文 摘要
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.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Rheumatoid arthritis (RA)
- Gout
- Erosive osteoarthritis
更多 鉴别诊断指南
- 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
更多 指南患者教育信息
Gout
Rheumatoid arthritis
更多 患者教育信息
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