5- PSORIATIC ARTHRITIS

• Psoriatic arthritis


  • Develops in 10% of patients with psoriasis, especially if nail disease
  • May present as different patterns of arthritis
• Patterns of psoriatic arthritis

  1. DIP arthritis

  2. Mono or oligo-arthritis

  3. Sacroiliitis

  4. Symmetrical seronegative polyarthritis (resembling RA)

  5. Arthritis mutilans: severe destruction of small bones in hands and feet
• DIP arthritis


  Most typical pattern of psoriatic arthritis
• DIP arthritis


  • Dactylitis (sausage fingers)
  • Nail pitting
  • X-ray: pencil-in-cup deformity
• 1. ray findings


  • Pencil in cup deformity in interphalangeal joint (bone erosions>> pointed appearance, concave articulating bone)
• Nail involvement


  • Pitting
• Treatment of psoriatic arthritis

  1. Analgesia, NSAIDs

  2. If local synovitis à steroid injection

  3. If severe à methotrexate, anti-TNF