SERONEGATIVE ARTHRITIS-PSORIATIC ARTHRITIS

SUMMARY

1. In 80% of patients, psoriasis precedes arthritis by 10 years.

2. Asymmetric arthritis or oligoarthritis: usually involves large joints like the knees, ankles, and wrists; typically < 3 joints are affected.

3. 20-30% of patients who have nail pitting (ice pick-like), onycholysis (separation of the nail from the nail bed), and "oil spots" (brownish discoloration under the nails) & sausage-shaped digits (dactylitis).

4. Ray diversity: mutilans in one, dactylitis in another, etc.

5. Chest wall pain due to costochandritis, sternoclavicular joint inflammation.

6. SAPHO syndrome: synovitis, acne, pustulosis, hyperosteosis, osteitis.

7. Systemic: uveitis, retinal inflammation, bowel disease (Crohn's disease); obesity, DM, CV disease (risk of AMI in young is 6-8x).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].