Участник:SaidWitherspoon286
Psoriatic arthritis (PA) is without doubt one of the commonest forms of inflammatory arthritis. Like its not so distant cousin, rheumatoid arthritis, PA is a systemic autoimmune driven form of arthritis. It is most common in individuals who have an extensive amount of psoriasis. Based on the Nationwide Psoriasis Foundation, between 10 per cent and 30 per cent of people with psoriasis will develop PA. Curiously, patients might develop the arthritis before they've medical psoriasis.
Most sufferers with psoriatic arthritis, if joint signs are minimal, often see a dermatologist earlier than realizing they've PA. Symptoms embrace swelling, warmth, redness, and ache involving not only the joints but the entheses (tendon attachments into the bone) as well. As well as, tendon sheaths within the fingers and toes can swell, inflicting what is termed a "sausage" digit. Stiffness in the morning is often present.
Patients with PA can have variants of the disease. Some patients have extra involvement of the backbone than others. PA is usually non-symmetric as opposed to rheumatoid arthritis which tends to be symmetric in presentation. It is this asymmetry that may be helpful for suspecting the diagnosis.
Along with the everyday rash of psoriasis, sufferers may have nail pitting or lifting up of the finger or toenail.
Like different autoimmune forms of arthritis, there is a systemic part to this disease. Particularly, sufferers with PA can develop eye inflammation.
Imaging procedures resembling magnetic resonance imaging (MRI) might help confirm the diagnosis. Specific adjustments on the entheses are attribute of PA.
Therapy starts with making the diagnosis. Illnesses that may be confused with PA are rheumatoid arthritis, gout (the serum uric acid will be elevated in sufferers with PA), fibromyalgia, pseudogout, ankylosing spondylitis, sarcoidosis, Lyme disease, and Reiter's disease.
The goals of proper remedy are to slow down the progress of the disease and restore function. A mixture of an anti-inflammatory drug and a disease-modifying anti-rheumatic drug (DMARD) is the standard starting point of treatment. While methotrexate is the DMARD of choice for rheumatoid arthritis, it might not work fairly as nicely in PA. Options embody sulfasalazine (Azulfidine), leflunomide (Arava), and hydroxychloroquine (Plaquenil).
In sufferers who don't respond within eight to 12 weeks, biologic therapy using a TNF inhibitor is the following logical step. Among the many options listed below are etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), and golimumab (Simponi).
Sufferers with a single infected joint or tendon may reply to steroid injection.
