Psoriatic Arthritis: Examination

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).
    • Oil stain nails (yellowish-brownish discoloration).
    • Onycholysis (yellowish-brownish dirty changes under the surface of the nail).
    • Crumb nails (thickened, dystrophic nails).
    • Missing cuticle (psoriatic focus on the nail wall).
  • Gait pattern (fluid, limping).
  • Body or joint posture (upright, bent, relieving posture).
  • Malpositions (deformities, contractures, shortenings).
  • Muscle atrophies (side comparison!, if necessary circumference measurements).
  • Joint (swelling (tumor), redness (rubor), hyperthermia (calor)).
  • Palpation of prominent bone points, tendons, ligaments; musculature; joint (joint effusion); soft tissue swelling; tenderness (localization!) [predominantly affected hands and feet and / or spine; it comes to:
    • Arthralgia (joint pain)
    • Joint swelling
    • Pressure painfulness of the joints movement restrictions
    • Stiffness of joints – morning stiffness lasting more than 60 minutes is almost always a sign of inflammatory joint disease]
• Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.