Fast Five Quiz: Can You Identify Psoriatic Arthritis and Initiate the Best Treatment Practices?

Herbert S Diamond, MD; Anwar Al Hammadi, MD

Disclosures

July 10, 2019

Extra-articular features are observed less frequently in patients with psoriatic arthritis than in those with rheumatoid arthritis (RA). In patients with psoriatic arthritis, synovitis has a predilection for the flexor tendon sheath, with sparing of the extensor tendon sheath; both tendon sheaths are commonly involved in persons with RA.

Subcutaneous nodules are rare in patients with psoriatic arthritis. If nodules are present in a patient who has psoriasis and arthritis, particularly if the rheumatoid factor titer is positive, they suggest the coincidental occurrence of psoriasis and RA.

Ocular involvement may occur in 30% of patients with psoriatic arthritis, including conjunctivitis in 20% of patients and acute anterior uveitis in 7%. In patients with uveitis, 43% have sacroiliitis and 40% are HLA-B27–positive. Scleritis and keratoconjunctivitis sicca are rare. Possible ocular findings also include iritis.

Inflammation of the aortic valve root, which may lead to insufficiency, has been described in six patients with psoriatic arthritis and is similar to that observed more frequently in persons with ankylosing spondylitis or reactive arthritis. Occasionally, patients with psoriatic arthritis may develop secondary amyloidosis.

For more on extra-articular features in psoriatic arthritis, read here.

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