Lupus hands mimicking psoriatic arthritis

Area of Science:

• Rheumatology
• Internal Medicine
• Clinical Case Study

Background:

• Chronic destructive arthritis can present with overlapping features across different autoimmune conditions.
• Differentiating between psoriatic arthritis (PsA) and other inflammatory arthropathies is clinically significant.
• Systemic lupus erythematosus (SLE) can manifest with diverse and sometimes unusual clinical presentations.

Purpose of the Study:

• To present a unique case of severe arthritis with imaging findings suggestive of PsA.
• To highlight the diagnostic challenge posed by overlapping clinical and imaging features in autoimmune diseases.
• To emphasize the importance of serological markers in diagnosing SLE, even with atypical presentations.

Main Methods:

• Case report of a 68-year-old woman with an 8-year history of chronic, destructive arthritis.
• Review of imaging findings that mimicked psoriatic arthritis.
• Analysis of serological markers to confirm systemic lupus erythematosus.
• Evaluation of associated clinical features, including a lupus panniculitis-like rash and interstitial lung disease.

Main Results:

• The patient exhibited severe arthritis with imaging characteristics resembling psoriatic arthritis.
• Serological tests confirmed the diagnosis of systemic lupus erythematosus.
• Cutaneous lupus panniculitis and interstitial lung disease were identified as systemic manifestations of SLE.

Conclusions:

• This case underscores the diagnostic complexity when arthritis mimics psoriatic arthritis but serological findings indicate systemic lupus erythematosus.
• Lupus panniculitis and interstitial lung disease can be significant systemic indicators of SLE.
• Accurate diagnosis relies on integrating clinical presentation, imaging, and definitive serological evidence.