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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