Psoriatic Arthritis | Hand & Wrist Exam - MedSchool
Sign up to start your free trial of MedSchool Premium!Get Started
 
Hand & Wrist Exam
 
 
 

Psoriatic Arthritis

 
 
Bookmark

Overview

    • 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
Last updated on July 7th, 2019
 
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
 
 

Read More...

Backhouse KM. Innervation of the Hand. Hand. 1975. 7:107.
De Souza RM, Choi D. Peripheral Nerve Lesions. Surgery. 2012; 30(3): 149-154.
Dinsdale G, Herrick AL. Vascular diagnostics for Raynaud’s phenomenon. J Vasc Diagn. 2014;2:127-39.
 Hainer BL, Matheson E, Travis Wilkes R. Diagnosis, treatment, and prevention of gout. American family physician. 2014 Dec 15;90(12). Hughes M, Herrick AL. Assessment and management of Raynaud's phenomenon. Prescriber. 2017 Jul;28(7):11-6. Lowe G, Tait C. Limb Pain and Swelling. Medicine. 2009 Feb; 37(2): 96-99. Ma L, Cranney A, Holroyd-Leduc JM. Acute monoarthritis: What is the cause of my patient's painful swollen joint?. Cmaj. 2009 Jan 6;180(1):59-65. Palmer KT. Pain in the Forearm, Wrist and Hand. Best Practice and Research Clinical Rheumatology. 2003; 17(1): 113-135. Reddy RS. Compson J. Examination of the Wrist - Surface Anatomy of the Carpal Bones. Current Orthopaedics. 2005; 19; 171-179. Ricceri F, Prignano F. Gottron papules: a pathognomonic sign of dermatomyositis. Cmaj. 2013 Feb 5;185(2):148-. Rothschild BM, Pingitore C, Eaton M. Dactylitis: implications for clinical practice. InSeminars in arthritis and rheumatism 1998 Aug 1 (Vol. 28, No. 1, pp. 41-47). WB Saunders. Siva CH, Velazquez CE, Mody A, Brasington RI. Diagnosing acute monoarthritis in adults: a practical approach for the family physician. American family physician. 2003 Jul 1;68(1):83-92. Skirven T. Clinical Examination of the Wrist. Journal of Hand Therapy. 1996 Apr-Jun; 9(2): 96-107. Thaper A, Zhang W, Wright G, Doherty M. Relationship between Heberden’s nodes and underlying radiographic changes of osteoarthritis. Annals of the rheumatic diseases. 2005 Aug 1;64(8):1214-6. Turesson C, O’fallon WM, Crowson CS, Gabriel SE, Matteson EL. Extra-articular disease manifestations in rheumatoid arthritis: incidence trends and risk factors over 46 years. Annals of the rheumatic diseases. 2003 Aug 1;62(8):722-7. Young D, Papp S, Giachino A. Physical Examination of the Wrist. Orthopedic Clinics of North America. 2007; 38(2): 149-65.
Feedback