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Hand & Wrist Exam

Psoriatic Arthritis

July 7th, 2019


  • 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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