Psoriatic arthritis: a systematic review

Abstract

Psoriatic arthritis is an inflammatory rheumatic disorder of unknown etiology occurring in patients with psoriasis. The Classification Criteria for Psoriatic Arthritis study group has recently developed a validated set of classification criteria for psoriatic arthritis with a sensitivity of 91.4% and a specificity of 98.7%. Three main clinical patterns have been identified: oligoarticular (≤ 4 involved joints) or polyarticular (≥ 5 involved joints) peripheral disease and axial disease with or without associated peripheral arthritis. In this context distal interphalangeal arthritis and arthritis mutilans may occur. According to other reports, also in our centre, asymmetric oligoarthritis is the most frequent pattern at onset. Axial disease has been estimated between 5% and 36% of patients. It is characterized by an irregular involvement of the axial skeleton with a predilection for the cervical spine. Recurrent episodes of enthesitis and dactylitis represent a hallmark of psoriatic arthritis. In around 20% of cases distal extremity swelling with pitting edema of the hands or feet is observed. Unilateral acute iridocyclitis, usually recurrent in alternate fashion, is the most frequent extra-articular manifestation, and accelerated atherosclerosis is the prominent comorbidity. The clinical course of peripheral and axial psoriatic arthritis is usually less severe than rheumatoid arthritis and ankylosing spondylitis, respectively. Local corticosteroid injections and non-steroidal anti-inflammatory drugs are recommended in milder forms. Sulphasalazine and methotrexate are effective in peripheral psoriatic arthritis. Recent studies have provided evidence on the efficacy of anti-tumor necrosis factor-α drugs to control symptoms and to slow or arrest radiological disease progression.

Psoriatic Arthritis Mutilans: Case Series and Literature Review

“…Psoriatic arthritis (PsA) is a seronegative spondyloarthropathy that develops in 1% to 39% of patients with psoriasis 1 . It may present clinically in different forms, including distal interphalangeal joint arthritis, asymmetrical oligoarthritis, symmetrical polyarthritis, spondylitis, and arthritis mutilans (AM) 2 .…”

Misalignment between Physicians and Patient Satisfaction with Psoriatic Arthritis Disease Control

“…Psoriatic arthritis (PsA) is a common chronic, disabling, immune-mediated disease, affecting the peripheral and axial joints, nails, and entheses, and is often associated with psoriatic skin lesions [1,2]. Patients with PsA experience inflammation, pain, and swelling of the joints, in addition to the scaling, itching, and skin pain associated with psoriasis [3].…”

Painful Spinal Conditions in Young Children and Adolescents

“…Also, there are other case studies that demonstrate that over half of the pediatric patients who have been examined in the orthopedic clinic for cases of low back pain had an underlying spinal injury [9]. In all these case studies, the common diagnoses were tumors, Scheuermann, spondylolisthesis, discitis and osteomyelitis [2,10].…”