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Psoriatic arthritis in the hand
1Tufts University School of Medicine, Boston, Massachusetts.
Hand Clinics
|May 1, 1989
Summary
Psoriatic arthritis, a distinct joint disease, causes severe deformity in its mutilans form. Treatment focuses on salvage surgeries for pain relief and improved joint positioning due to limited motion gains.
Area of Science:
- Rheumatology
- Orthopedics
- Dermatology
Background:
- Psoriatic arthritis is a distinct polyarthropathy associated with psoriasis.
- Clinical manifestations include stiffness, contractures, digital swelling, and joint pain.
- Psoriatic arthritis mutilans represents a severe, destructive osteolytic form.
Purpose of the Study:
- To describe the clinical and radiographic features of psoriatic arthritis.
- To detail the presentation and progression of psoriatic arthritis mutilans.
- To outline surgical management strategies for psoriatic arthritis mutilans.
Main Methods:
- Review of clinical presentations and radiographic findings in psoriatic arthritis patients.
- Analysis of characteristic radiographic features of psoriatic arthritis mutilans.
- Evaluation of surgical outcomes for salvage procedures.
Main Results:
- Psoriatic arthritis presents with varied symptoms including joint pain and swelling.
- Psoriatic arthritis mutilans shows rapid osteolysis, joint destruction, and spontaneous fusion.
- Radiographs indicate widened joint spaces and distal tuft resorption.
Conclusions:
- Psoriatic arthritis mutilans leads to significant deformity and bone resorption.
- Surgical interventions primarily aim to relieve pain and improve joint position.
- Functional improvement after surgery for psoriatic arthritis mutilans is often limited.