Psoriatic Arthritis: Pathogenesis and Clinical findings
In tendons and connective tissues:
• Enthesitis - Pain/tenderness over ligament insertion into bone
• Dactylitis - Inflammation of entire digit- soft tissue and joints are inflamed
In skin:
• Psoriatic plaques on skin, pitting, ridging, oil spots, onycholysis, discoloration and hyperkeratosis
In Joints:
1. Asymmetric oligoarthritis
2. Arthritis of DIP joints
3. Symmetric polyarthritis (like RA)
4. Axial involvement (unknown reason, probably due to "biomechanical", "innervation" & "vascularity")
5. Arthritis mutilans (aggressive & destructive)
• X-ray: Periostitis; syndesmophytes, erosions, pencil in cup deformities due to osteolysis (IP joints), ankylosois of IP joints
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