Page 32 - Waterfall Issue 10 2021

Waterfall News

Living with and managing

pSoRIATIC

ARTHRITIS

Both men and women are equally affected by By Dr Anita Lai, Rheumatologist

psoriatic arthritis, with the peak onset being practising at Netcare Waterfall City
Hospital
in the 40-to-50-year age group.

p soriatic arthritis (PsA) is a complex chronic 2. Arthritis mutilans – a rare, severe, deforming, and

destructive form of PsA, which affects the small
inflammatory joint disease associated with psoriasis,
joints in the fingers and toes closest to the nail.
a skin condition, which manifests in diverse ways.
3. And lastly, the subgroup with predominant
SIgNS AND SympTomS oF psA axial involvement that primarily involves the
There are five broad clinical subgroups: spine and sacroiliac joints in the pelvis.
• The oligoarticular subgroup involves four or fewer joints
and usually affects the distal interphalangeal (the joint In terms of signs and symptoms, the following should be noted:
that connects the bones at the tips of the fingers), the Enthesitis is inflammation where a tendon, ligament,
proximal interphalangeal (the finger joints that grip), fascia, muscle, or joint capsule attaches to the bone.
and the metatarsal-phalangeal joints (the joints of the The most common sites of involvement are the Achilles
toes). It is typically asymmetrical in its distribution. tendon and the plantar fascia – the latter being a fibrous
• The polyarticular subgroup involves five or band of tissue that runs along the sole of the foot.
more joints and has a symmetrical distribution
that resembles rheumatoid arthritis. Dactylitis or sausage digit is the inflammation of an
• Of the remaining three subgroups, each entire digit. It most commonly occurs in the third
constitutes about 5% of cases. They include: and fourth toes but may also involve the fingers.
1. Predominant distal interphalangeal (the joint that
connects the bones at the tips of the fingers), which The extra-articular manifestations occur in 49%
is the classical pattern of PsA presentation. of patients. They include psoriasis with skin and

30 Waterfall Issue 10 2021