Medical history (history of illness) represents an important component in the diagnosis of psoriatic arthritis. Family history Is there a frequent history of skin disease in your family? Are there frequent diseases of bones/joints in your family? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical … Psoriatic Arthritis: Medical History
Musculoskeletal system and connective tissue (M00-M99). Crohn’s arthritis – Joint inflammation (arthritis) as a concomitant disease in Crohn’s disease (inflammatory bowel disease (IBD)). Heberden’s arthritis – form of osteoarthritis affecting the finger end joints (distal interphalangeal joints, DIP) and associated with the formation of Heberden’s nodes. Ankylosing spondylitis (ankylopoietic spondylarthritis) – seronegative spondyloarthropathy; chronic inflammatory … Psoriatic Arthritis: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by psoriatic arthritis: Eyes and eye appendages (H00-H59). Uveitis (inflammation of the middle eye skin). Endocrine, nutritional, and metabolic diseases (E00-E90). Obesity (overweight) Diabetes mellitus type 2 (insulin resistance) Hyperlipidemia / dyslipidemia (lipid metabolism disorders). Cardiovascular system (I00-I99) Acute coronary syndrome (AKS … Psoriatic Arthritis: Secondary Diseases
The CASPAR criteria are used to classify psoriatic arthritis: Classification Criteria for the Diagnosis of Psoriatic Arthritis. Psoriatic arthritis is considered diagnosed when there is inflammatory disease of joints, the spine, or the entheses (tendon attachments or sheaths) and three items also arise from the criteria listed below: Criterion Points Psoriasis currently present 2 Or … Psoriatic Arthritis: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin Predilection sites (sites where the changes predominantly occur) of psoriasis are knees, elbows and scalp, sacral region (sacral region), anal region Nail changes/nail symptoms Spotted nails (pinhead-sized indentations). … Psoriatic Arthritis: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count CRP (C-reactive protein) [+ /-] or ESR (erythrocyte sedimentation rate) [+ /-]. HLA-B27 (positive in 50-70% of cases) – indication of spondyloarthritides (inflammatory rheumatic disease predominantly affecting the spine). Anti-citrulline antibodies – antibodies against cyclic citrullinated peptides (ACPA, CCP-Ak, anti-CCP) [up to 8% positive]. … Psoriatic Arthritis: Test and Diagnosis
Therapy goals Improvement of the symptomatology Low disease activity, ideally remission (disappearance of disease symptoms). Prevention of structural damage and normalization of function. Therapy recommendations Therapy is based on the treat-to-target concept, i.e., tight therapeutic timeline and orientation to strict goals. For the relief of musculoskeletal symptoms: Non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac or … Psoriatic Arthritis: Drug Therapy
Obligatory medical device diagnostics. Radiographic examination of the spine or other symptomatic joints, especially small joints such as finger and toe joints Skeletal scintigraphy (nuclear medicine procedure that can show functional changes in the skeletal system, in which regionally (locally) pathologically (pathologically) increased or decreased bone remodeling processes are present).
If joint pain or discomfort persists despite drug therapy, it is possible to perform both prophylactic and reconstructive surgery: Synovectomy: A synovectomy involves the complete removal of the diseased synovium of a joint (articulosynovectomy) or the tendon sheaths (tenosynovectomy). The operation can be performed in the early stages of the disease to delay the destruction … Psoriatic Arthritis: Surgical Therapy
General measures Avoid dehydration and irritation of the skin by balancing skin care. Suitable care products are a greasy skin care in combination with keratolytics. Observance of the general hygiene measures! Nicotine restriction (refrain from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Review … Psoriatic Arthritis: Therapy
To prevent psoriatic arthritis, attention must be paid to reducing individual risk factors. The following trigger factors (possible triggers) are suspected: Bacterial infections (eg, group A streptococci). Inflammatory lesions such as dental granulomas (small nodules in the tooth area). Joint trauma (joint injuries), joint stresses. Proliferative-destructive inflammation at joint soft tissues, synovium (synovial fluid), bone. … Psoriatic Arthritis: Prevention
The following symptoms and complaints may indicate psoriatic arthritis: Arthralgia* (joint pain). Joint swelling of the hands and feet (metacarpo or metatarsophalangeal joints, proximal and distal interphalangeal joints) in the sense of dactylitis (Latin: daktyl = fingers or toes and “itis” = inflammation; finger inflammation or also toe inflammation), which from the appearance lead to … Psoriatic Arthritis: Symptoms, Complaints, Signs
