Psoriatic Arthritis Mutilans: Clinical and Radiographic Criteria. A Systematic Review

Haddad, Amir; Somaily, Mansour; Fazelzad, Rouhi; Kron, Amie; Chau, Cathy; Chandran, Vinod

doi:10.3899/jrheum.141545

Cited by 25 publications

(14 citation statements)

References 66 publications

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“…PsA can present with oligoarticular joint involvement that is typically asymmetric or as polyarticular disease affecting five or more joints, usually with a symmetric distribution similar to that of rheumatoid arthritis (RA) [3, 4]. In approximately 5% of cases, PsA can present with arthritis mutilans, which is a severe, destructive, deforming manifestation characterized by telescoping digits [5]. Some patients with PsA show symptoms only in distal joints (e.g., interphalangeal hand and foot joints, including distal interphalangeal joints), while others have disease that predominantly affects the axial skeleton (i.e., spine and sacroiliac joints) [1].…”

Section: Introductionmentioning

confidence: 99%

Psoriatic Arthritis: What is Happening at the Joint?

Belasco¹,

Wei²

2019

Rheumatol Ther

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Psoriatic arthritis (PsA) is a heterogeneous and inflammatory disease with diverse clinical manifestations, including psoriasis, nail psoriasis, peripheral joint disease, axial joint disease, enthesitis, and dactylitis. Typically, this varied clinical presentation complicates the clinician’s ability to distinguish PsA from other forms of arthritis. In the synovium of individuals with PsA, upregulation of the genes WNT3A , BMPR2 , and TGFBR1 results in bone erosion and new bone formation, a pattern unique to the disease. Additionally, genes associated with angiogenesis and vascularization such as VEGF and TGFB1 facilitate inflammation and joint damage. Gross pathogenesis of PsA is driven by proinflammatory cytokines, and key cytokines affecting joint structures include tumor necrosis factor-α, interleukin (IL)-6, IL-17A, IL-21, IL-22, and IL-23. Early diagnosis is critical for providing treatment that prevents irreversible disease progression and function loss. This narrative review discusses differentiation of PsA from other forms of arthritis. Additionally, we detail the role of cytokines at the joint in mediating PsA pathogenesis. Funding: Novartis Pharmaceuticals Corporation.

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Section: Introductionmentioning

confidence: 99%

Psoriatic Arthritis: What is Happening at the Joint?

Belasco¹,

Wei²

2019

Rheumatol Ther

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“…One of the clinical manifestations of this condition is shortening of one or more digits due to severe osteolysis, a deformity called “opera glass finger” or “telescoping finger.” The radiographic findings of PsA mutilans suggest gross osteolysis and pencil-in-cup deformities in joints, as well as rapid progress. Radiographic features in PsA mutilans include bone resorption (41%), joint ankylosis (21%), pencil-in-cup changes (16%), total joint erosion (14%), and joint subluxation (7%) [ 8 ]. In the present case, severe progression of bone resorption, joint erosion, and joint subluxation were observed in the feet, particularly in the PIP joints.…”

Section: Discussionmentioning

confidence: 99%

Delayed Diagnosis of Psoriatic Arthritis Mutilans due to Arthritis Prior to Skin Lesion

Mochizuki¹,

Ikari

Okazaki

2018

Case Reports in Rheumatology

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Psoriatic arthritis (PsA) is a type of inflammatory arthritis characterized by cutaneous psoriasis, peripheral joint damage, axial joint damage, and enthesitis and is usually diagnosed after the appearance of psoriatic skin disease. PsA mutilans is relatively rare in Japan. In the present case, the patient was diagnosed with PsA with foot mutilans deformity only. Hand and spinal radiograph findings were unremarkable. As in the present case arthritis is occurred prior to the onset of skin lesion, we should make early diagnosis to prevent mutilans deformity.

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“…Asymmetric oligoarthritis is more common in men and often involves the distal interphalangeal joints, larger joints, and feet [17]. About 5% of patients with peripheral arthritis develop a severe, destructive form of PsA known as arthritis mutilans, which is associated with telescoping digits, bone destruction and deformity, and profound functional disability [18].…”

Section: Diagnosing Psa: a Careful Look At Patient History And Identimentioning

confidence: 99%

A Review for Physician Assistants and Nurse Practitioners on the Considerations for Diagnosing and Treating Psoriatic Arthritis

Giannelli¹

2018

Rheumatol Ther

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Psoriatic arthritis (PsA) is a clinically heterogeneous form of progressive inflammatory arthritis that affects up to 30% of patients with psoriasis. The rapid rate of progression associated with PsA makes early-disease diagnosis and treatment crucial to patients’ quality of life and long-term health. With the aim of providing clinical guidance to physician assistants and nurse practitioners, this article gives an overview of the different PsA clinical domains, including peripheral arthritis, axial disease, enthesitis, dactylitis, skin disease, and nail dystrophy, which should be considered as part of diagnosis and treatment strategies. The efficacy of different therapies across these PsA domains is reviewed within the context of current PsA treatment guidelines while considering more recent data on newly approved therapies for PsA. Funding : Novartis Pharmaceuticals Corp., East Hanover, NJ, USA.

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Psoriatic Arthritis Mutilans: Clinical and Radiographic Criteria. A Systematic Review

Abstract: We have identified 8 definitions of PAM, and synthesized the clinical and radiographic items that are important for the classification of PAM. We have established the groundwork for future development classification criteria for PAM.

Cited by 25 publications

References 66 publications

Psoriatic Arthritis: What is Happening at the Joint?

Psoriatic Arthritis: What is Happening at the Joint?

Delayed Diagnosis of Psoriatic Arthritis Mutilans due to Arthritis Prior to Skin Lesion

A Review for Physician Assistants and Nurse Practitioners on the Considerations for Diagnosing and Treating Psoriatic Arthritis

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