Fast Five Quiz: Psoriatic Arthritis Presentation and Diagnosis

Herbert S. Diamond, MD

Disclosures

January 29, 2020

Recognizing the patterns of joint involvement seen in psoriatic arthritis is essential to its diagnosis. Five patterns have been identified. They are:

  • Asymmetrical oligoarticular arthritis

  • Symmetrical polyarthritis

  • Arthritis mutilans

  • Distal interphalangeal arthropathy

  • Spondylitis with or without sacroiliitis

Ocular involvement may occur in 30% of patients with psoriatic arthritis, especially conjunctivitis (20% of patients) and acute anterior uveitis (7% of patients). In patients with uveitis, 43% have sacroiliitis and 40% are HLA-B27–positive. Scleritis and keratoconjunctivitis sicca can occur, but they are rare.

Subcutaneous nodules are rarely found in patients with psoriatic arthritis. If nodules are present in a patient who has psoriasis and arthritis, particularly if the rheumatoid factor (RF) titer is positive, they may indicate the coincidental occurrence of concomitant psoriasis and rheumatoid arthritis.

Learn more about the physical examination of patients with psoriatic arthritis.

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