Diagnosis
Signs of Psoriatic Arthritis
General Signs
- Symmetric polyarthritis affecting digits as a whole (rather than in rays of digits)
- Nail changes - onycholysis, pitting, crumbling of the nail plate
- Psoriatic plaques - particularly on the extensor surfaces of joints, scalp, periumbilicus, skin folds
- Dactylitis: 'sausage-like' digits due to synovitis of each joint
- Enthesitis: inflammation of a tendon insertion; affecting the Achilles tendon or the plantar fascia
- Evidence of sacroiliitis - tender sacroiliac joints
Signs of Complications
- Evidence of iritis - painful, erythematous eye
X-Ray Findings in Psoriatic Arthritis
- Pencil-in-cup deformity: erosions with new bone formation
- Dactylitis: soft tissue swelling in all of the joints of a single digit
- Fluffy periostitis: cortical thickening
- Ankylosis: fusion of joints
- Sacroiliitis
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