Musculoskeletal

Psoriatic arthritis

A heterogeneous inflammatory arthritis associated with psoriasis, characterised by combinations of peripheral arthritis, axial disease, enthesitis, dactylitis and nail involvement.

Definition

Psoriatic arthritis is an inflammatory arthritis associated with psoriasis or a psoriasis family history, affecting peripheral joints, axial joints, entheses and digits in variable combinations.

First principles

Psoriatic arthritis can affect several musculoskeletal domains

Psoriatic arthritis may present as asymmetric oligoarthritis, polyarthritis, distal interphalangeal disease, axial spondyloarthritis, enthesitis, dactylitis or destructive arthritis. The pattern can change over time, so assessment should cover joints, spine, entheses, digits, skin and nails rather than counting swollen joints alone.

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