Internal Medicine bundle

  1. What are at least 5 physical findings in Psoriatic Arthritis.
    Pattern: distal arthritis - DIPs, oligoarthritis <5 (sm or lar), dustructive arthritis, spondyloarthritis

    • -Enthesitis of achilles
    • -Tenosynovitis esp hands
    • -Dactylitis (sausage digit)
    • -nail pitting
    • -Uveitis
  2. What is the initial treatment of Psoriatic Arthritis?
  3. What labs can be drawn to diagnose Psoriatic arthritis?
    No labs will give you a diagnosis. However, you may be able to rule out other causes of inflamatory arthritis.
  4. What are the major ddx or similar inflammatory arthritis that should be investigated in a work up of psoriatic arthritis?
    • -Reactive Arthritis - has oligoarthritis, dactylitis, enthesitis and spondyloarthritis.
    • -Rheumatoid arthritis
    • -Gout - can coexisit too!
  5. What are the radiologic features of psoriatic arthritis?
    • -Erosive + new bone formation
    • -lysis of terminal phalanges
    • -Pencil-in-cup appearance
    • -Fluffy periostitis and new bone formation at site of enthesitis.
    • -Joint lysis AND ankylosis
  6. What are the classification criteria for Psoriatic Arthritis set by The Classification of Psoriatic Arthritis study CASPAR?
    • *Presence of inflammatory arthritis
    • PLUS 3 points from:
    • -Skin psoriasis 2pts
    • -Family history of psoriasis 1pt if pt does not have psoriasis lesions
    • -Onycholysis or nail pitting 1pt
    • -Dactylitis (past or presenst) 1pt
    • -Negative RF 1pt
    • -Juxtaarticular bone formation 1pt
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