Psoriatic Arthritis: A Roentgenologic Study

Vasey

et al. 1982

Arthritis & Rheumatism

Light and electron microscopic studies were performed on the synovial membranes from the large joints of 12 patients with psoriatic arthritis. The most significant histopathologic findings were vascular changes that were characterized by endothelial cell swelling accompanied by inflammatory cell infiltration and marked thickening of the vessel wall. Fibrosis of the subsynoviocyte tissue was also prominent, especially in patients with chronic disease. Villi were not prominent, and the lining layer was not thickened. Both type A and B cells were seen; none had significant abnormalities. No electrondense deposits were observed. These findings lend further support to the theory that microvascular changes play a significant role in the pathogenesis of psoriasis and its related arthritis.Psoriatic arthritis is a distinct clinical entity that is separate from the other inflammatory arthritides. It occurs in about 5-7% of patients with psoriasis (1-3). Since the original description by Alibert (4), several

mentioning

confidence: 99%

Vascular changes in psoriatic synovium. a light and electron microscopic study

Vasey

et al. 1982

Arthritis & Rheumatism

J Clin Exp Dermatol Res

“…The 'opera glass hand' in which fingers can be pulled in and out results from gross destruction and absorption of bones. The heads of metacarpals and metatarsals may completely disappear leaving a tapered bone looking like a sharpened pencil [4]. Treatment includes non steroidal anti inflammatory drugs.…”

Section: Case Reportmentioning

confidence: 99%

Arthritis Mutilans: A Case Report

Hassan¹

2013

A fifty year old farmer presented with severe joint pain and swelling in the small joints of hands and feet and a rapidly progressive downhill course over a period of three months. The patient developed joint deformities of hands and feet with digital resorption of the terminal phalanges. Five months after the start of joint deformities, the patient developed well defined erythematosquamous plaques with silvery white scales on the extensor aspect of limbs and scalp. The nails had pitting, discoloration and sub ungual hyperkeratosis. The clinical and histopathological diagnosis was consistent with Psoriasis. A radiograph of hands and feet revealed splaying of the base of the phalanges with tapering of the ends of metacarpals and metatarsals showing 'pencil-in-a cup' deformity. Distal inter phalangeal joints were also involved. A diagnosis of Psoriasis with Arthritis Mutilans was made. The patient was put on injectable Methotrexate and oral steroids.

“…Résorption de la houppe phalangienne (acroostéolyse) ou ostéopériostite de la phalangette (phalangette et articulation interphalangienne distale), territoire plus fibreux que synovial, et reproduisent les images classiques de l'enthésite : ostéolyse, ankylose, périostite [8][9][10]. Leur évolution dans le temps est celle d'une enthésite où l'ostéite (ostéolyse) précède l'ossification cicatricielle (ankylose) [1,5,7,10] (Fig.…”

Section: Atteinte Des Orteilsunclassified

The foot in psoriatic arthritis

Fournie

2009

Med Chir Pied

L'atteinte du pied dans le rhumatisme psoriasique est fréquente et s'observe dans un peu plus de la moitié des cas. Elle intéresse surtout le calcanéus et les orteils, mais toutes les structures du pied peuvent être touchées. La talalgie plantaire est la manifestation clinique la plus habituelle, et les lésions des orteils, surtout celles associées à l'atteinte cutanée ou relevant d'une enthésite, sont parmi les manifestations les plus originales de cette arthropathie. Sa gravité tient aux destructions articulaires, parfois mutilantes, qui surviennent dans environ un tiers des cas, et qui sont inhabituelles dans les autres spondylarthrites. Mots clés Rhumatisme psoriasique · PiedAbstract In over half the observed cases of psoriatic arthritis, the foot is affected. The calcaneus and the toes are primarily affected, but all the parts of the foot can also be affected. Plantar talalgia is the most frequent clinical manifestation and the lesions of the toes, especially those involving enthesitis, are among the most original manifestations of this arthropathy. The seriousness of this complication depends on the destruction of the joints, sometimes involving mutilation, which occurs in about one-third of the cases and which is unusual in other forms of spondylarthritis.