scholarly journals Delayed Diagnosis of Psoriatic Arthritis Mutilans due to Arthritis Prior to Skin Lesion

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Takeshi Mochizuki ◽  
Katsunori Ikari ◽  
Ken Okazaki
Keyword(s):  
Psoriatic Arthritis ◽  
Skin Lesion ◽  
Early Diagnosis ◽  
Skin Disease ◽  
Inflammatory Arthritis ◽  
Delayed Diagnosis ◽  
Joint Damage ◽  
Psoriatic Skin ◽  
Spinal Radiograph ◽  
Arthritis Mutilans

Psoriatic arthritis (PsA) is a type of inflammatory arthritis characterized by cutaneous psoriasis, peripheral joint damage, axial joint damage, and enthesitis and is usually diagnosed after the appearance of psoriatic skin disease. PsA mutilans is relatively rare in Japan. In the present case, the patient was diagnosed with PsA with foot mutilans deformity only. Hand and spinal radiograph findings were unremarkable. As in the present case arthritis is occurred prior to the onset of skin lesion, we should make early diagnosis to prevent mutilans deformity.

scholarly journals Recent advances in understanding and managing psoriatic arthritis

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2670 ◽  
Author(s):  
Dafna D. Gladman
Keyword(s):  
Psoriatic Arthritis ◽  
Early Diagnosis ◽  
Clinical Laboratory ◽  
Joint Damage ◽  
Screening Tools ◽  
Therapeutic Interventions ◽  
Joint Disease ◽  
New Therapeutic Approaches ◽  
Recent Advances ◽  
And Function

This article reviews recent advances in psoriatic arthritis (PsA) over the past several years with emphasis on early diagnosis, better understanding of pathogenesis, and new therapeutic approaches. Early diagnosis is important, since people who present late do not fare as well. There are a number of clinical, laboratory, and ultrasound features that can help identify patients destined to develop PsA, and several screening tools have been developed. It is recognized that genetic and epigenetic factors, as well as T cells and cytokines, play a role in the pathogenesis of PsA, and several targets have been identified for therapeutic interventions. New therapies have been developed and tested in PsA and have been found to be highly effective for both skin and joint manifestations of the disease. The expectation is that, in the future, PsA patients will be treated early and more aggressively and that there will not be significant progression of joint damage. Moreover, with effective treatment of the skin and joint disease and management of risk factors for the comorbidities, we can expect to reduce their occurrence and further reduce the excess mortality and reduced quality of life and function in these patients.

scholarly journals Radiographic development during three decades in a patient with psoriatic arthritis mutilans

2015 ◽  
Vol 4 (7) ◽  
pp. 205846011558809 ◽  
Author(s):  
Leena Laasonen ◽  
Björn Guðbjörnsson ◽  
Leif Ejstrup ◽  
Lars Iversen ◽  
Thomas Ternowitz ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Early Diagnosis ◽  
Effective Treatment ◽  
Typical Case ◽  
Rare Form ◽  
Pip Joint ◽  
Hands And Feet ◽  
Arthritis Mutilans ◽  
Ratingen Score

Psoriatic arthritis mutilans (PAM) is the most severe and rare form of psoriatic arthritis (PsA). We describe radiological development in a typical case of PAM covering three decades in order to elucidate the need for early diagnosis of PAM. Radiographs of hands and feet, taken from 1981 to 2010, were evaluated using the Psoriatic Arthritis Ratingen Score (PARS). When PsA was diagnosed, in 1981, gross deformity was observed in the second PIP joint of the left foot. Several pencil-in-cup deformities and gross osteolysis were present in the feet in the first decade of the disease. Over 10 years, many joints had reached maximum scores. During the follow-up, other joints became involved and the disease developed clinically. Reporting early signs suggestive of PAM, e.g. pencil-in cup deformities and gross osteolysis in any joint, should be mandatory and crucial. This would heighten our awareness of PAM, accelerate the diagnosis, and lead to improved effective treatment in order to minimize joint damages resulting in PAM.

scholarly journals Identification of Patients With Early Rheumatoid Arthritis: Challenges and Future Directions

2006 ◽  
Vol 13 (2-4) ◽  
pp. 295-297 ◽  
Author(s):  
Catalina Orozco ◽  
Nancy J. Olsen
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Diagnosis ◽  
Inflammatory Arthritis ◽  
Gene Expression Analysis ◽  
Adult Population ◽  
Joint Damage ◽  
Early Arthritis ◽  
Future Directions ◽  
Serologic Markers

Rheumatoid arthritis (RA) is the most common form of inflammatory arthritis that affects the adult population. Early diagnosis and treatment are the cornerstones to prevent joint damage and avoid long-term costs and disability. This article reviews the limitations of the currently available tools for the evaluation of patients with early arthritis, including clinical assessment, serologic markers and imaging modalities. It also discusses gene expression analysis, a newer and potentially promising approach to the early diagnosis of RA.

Safety and Efficacy of Therapies for Skin Symptoms of Psoriasis in Patients with Psoriatic Arthritis: A Systematic Review

2014 ◽  
Vol 41 (11) ◽  
pp. 2301-2305 ◽  
Author(s):  
Wolf-Henning Boehncke ◽  
David Alvarez Martinez ◽  
James A. Solomon ◽  
Alice B. Gottlieb
Keyword(s):  
Systematic Review ◽  
Psoriatic Arthritis ◽  
Skin Disease ◽  
Psoriatic Skin ◽  
Safety And Efficacy ◽  
Psoriatic Disease ◽  
Skin Symptoms ◽  
Guidelines And Recommendations ◽  
Systemic Therapies

Numerous guidelines and recommendations exist for the treatment of psoriasis in various populations. One important population is patients with psoriatic arthritis (PsA) who have symptoms of both joint and skin disease. In patients with both facets of psoriatic disease, skin and joints must be treated separately, but also simultaneously. As several systemic therapies are approved for either one or both, the concept of treating both facets with the same drug is feasible. This review summarizes evidence from studies in patients with PsA on the efficacy of these drugs on psoriatic skin disease in these patients.

scholarly journals Short-Term Total Hip Arthroplasty Outcomes in Patients With Psoriatic Arthritis or Psoriatic Skin Disease Compared to Patients With Osteoarthritis

2016 ◽  
Vol 68 (2) ◽  
pp. 410-417 ◽  
Author(s):  
Lisa A. Mandl ◽  
Rebecca Zhu ◽  
Wei-Ti Huang ◽  
Meng Zhang ◽  
Michael M. Alexiades ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Skin Disease ◽  
Psoriatic Skin ◽  
Short Term ◽  
Total Hip

Overview of psoriatic arthritis pathogenesis

2018 ◽  
Author(s):  
Kurt de Vlam
Keyword(s):  
Rheumatoid Arthritis ◽  
Immune Response ◽  
Psoriatic Arthritis ◽  
Environmental Factors ◽  
Rheumatic Diseases ◽  
Skin Disease ◽  
Inflammatory Arthritis ◽  
Heterogeneous Group ◽  
Chronic Inflammatory Arthritis

Psoriatic arthritis (PsA) is a chronic inflammatory arthritis occurring in patients with psoriasis. Some consider it as part of the heterogeneous group of diseases unified in the concept of spondyloarthritis (SpA). At least some subtypes, such as the oligoarticular and axial subtypes, can be classified as SpA. The aetiology and pathogenesis are poorly understood. An enthesitis-based model was proposed to unify skin and joint manifestation and to differentiate PsA from other rheumatic diseases such as rheumatoid arthritis and osteoarthritis. The development of PsA results from the interplay of genes, the immune response, and interaction with environmental factors. The fact that more than 80% of patients with PsA have precedent or simultaneous psoriasis suggests that the skin disease is almost a ‘condicio sine qua non’ for the development of PsA.

Plain radiography

2018 ◽  
Author(s):  
William Tillett ◽  
Neil McHugh
Keyword(s):  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Inflammatory Arthritis ◽  
Joint Damage ◽  
Axial Skeleton ◽  
Joint Space ◽  
Plain Radiography ◽  
Biologic Drugs ◽  
Erosive Disease ◽  
Radiographic Features

Psoriatic arthritis is a destructive inflammatory arthritis that can affect the peripheral and axial skeleton of patients with psoriasis. Plain radiography has formed an important part in defining psoriatic arthritis as a distinct clinical entity, from early work reporting on distinguishing features to more recent inclusion of osteoproliferation in the CASPAR classification criteria. Plain radiography is accessible, inexpensive and remains the standard measure of assessing damage in inflammatory arthritis. Originally considered a benign disease psoriatic arthritis is now recognised to be destructive and progressive, though not as aggressive as rheumatoid arthritis. Peripheral joint damage is characterised by erosions, joint space narrowing, osteoproliferation, osteolysis and ankylosis. Approximately twenty percent of patients have erosive disease at diagnosis progressing to approximately half of all patients by three years disease duration. In its most severe form, psoriatic arthritis mutilans, digits become shortened from gross bone resorption (osteolyisis) leading to severe functional impairment and disability. Spondyloarthritis may affect between 25-70% of patients with PsA. The radiographic features of Psoriatic Spondyloarthritis differ from Ankylosing Spondylitis, in that sacroiliitis is often asymmetrical and less severe, the cervical spine is frequently involved and syndesmophytes are asymmetrical and para-marginal. Overall radiographic features are less severe than ankylosing spondylitis. The natural history of both peripheral and axial radiographic damage in psoriatic arthritis in the modern era of early diagnosis, tight disease control and biologic drugs has yet to be established.

scholarly journals Gold Finger: Metal Jewellery as a Disease Modifying Antirheumatic Therapy!

2009 ◽  
Vol 2009 ◽  
pp. 1-2
Author(s):  
T. Hlaing ◽  
S. Ramteke ◽  
K. Binymin
Keyword(s):  
Psoriatic Arthritis ◽  
Inflammatory Arthritis ◽  
Unusual Case ◽  
Joint Damage ◽  
Ring Finger ◽  
Immune Disease ◽  
Mri Scan ◽  
Antirheumatic Therapy ◽  
Advanced Degrees ◽  
Pip Joint

Polyarticular psoriatic arthritis is a chronic, progressive and disabling auto-immune disease often affecting the small joints of the hands in a symmetrical fashion. The disease can progress rapidly causing joint swelling and damaging cartilage and bone around the joints resulting in severe deformities. We report a very unusual case of a 49-year-old woman who presented with polyarticular psoriatic arthritis affecting all proximal interphalangeal (PIP) joints of both hands except the left ring finger PIP joint. On clinical examination there was no evidence of arthritis in the left ring finger PIP joint. We confirmed the paucity of joint damage in the PIP joint of the left ring finger using more modern imaging modalities such as musculoskeletal ultrasound and MRI scan of the small joints of the hands. All other PIP joints in both hands demonstrated advanced degrees of joint damage secondary to chronic psoriatic inflammatory arthritis. We postulated that wearing a gold wedding ring has helped protecting the PIP joint of the left ring finger from the damaging effect of inflammatory arthritis. The possible mechanisms by which metal jewellery (gold ring) confer protection to adjacent joints was discussed.

GRAPPA 2013 Annual Meeting, Rheumatology Updates: Psoriatic Arthritis (PsA) Biomarker Project, Arthritis Mutilans, PsA-Peripheral Spondyloarthritis Epidemiology Project

2014 ◽  
Vol 41 (6) ◽  
pp. 1244-1248 ◽  
Author(s):  
Oliver FitzGerald ◽  
Philip J. Mease ◽  
Philip S. Helliwell ◽  
Vinod Chandran
Keyword(s):  
Psoriatic Arthritis ◽  
Annual Meeting ◽  
Joint Damage ◽  
Classification Criteria ◽  
Undifferentiated Arthritis ◽  
Psoriatic Disease ◽  
Inflammatory Bowel ◽  
Peripheral Spondyloarthritis ◽  
Arthritis Mutilans ◽  
Made In

At the 2013 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), several key GRAPPA projects on musculoskeletal aspects of psoriatic disease were reviewed. In this article, lead investigators summarize the progress made in a multicenter study, the PsA BioDam (Psoriatic Arthritis Biomarkers for Joint Damage), to identify soluble biomarkers for joint damage, as well as developing classification criteria for arthritis mutilans. Also reviewed are concepts and rationale behind a proposal to study classification criteria for peripheral spondyloarthritis, including PsA, reactive arthritis, inflammatory bowel disease-associated arthritis, and undifferentiated arthritis.

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