Clinical features

Clinical features

Psoriatic arthritis may begin gradually with mild symptoms or may follow joint injury in some cases (1).

Symptoms may vary from mild to very severe.

Characteristic features include:

• stiffness
• pain
• swelling tenderness of the joints and surrounding ligaments and tendons (dactylitis and enthesitis) (1)

The major types of psoriatic arthritis include:

• asymmetrical oligoarthritis characterised by:
  • large joint mono or oligoarthritis
  • scattered knuckle joint involvement
• symmetrical polyarthritis indistinguishable from rheumatoid arthritis
• psoriatic spondylitis:
  • primarily sacro-ilitis
  • also affects the spine
• arthritis mutilans:
  • severe, disabling arthritis with osteolysis
  • mainly involves the small joints of the hands and feet
• distal interphalangeal arthritis with nail dystrophy

Dactylitis also known as sausage shaped digits (due to enthesitis of the tendons and ligaments and synovitis involving the whole finger) are characteristic of psoriatic arthritis in the hands (1).

Reference:

• 1. American Academy of Dermatology 2008. Guidelines of care for the management of psoriasis and psoriatic arthritis - Section Psoriatic arthritis: Overview and guidelines of care for treatment with an emphasis on the biologic