Psoriatic arthritis

Discussion:

A case of psoriatic arthritis in a patient with a longstanding background of psoriasis.

Psoriatic arthritis is a seronegative spondyloarthropathy characterized by its association with psoriatic skin changes.

It predominantly affects the DIP joints with the hands being more commonly affected than the feet. While the appearance can be quite characteristic on imaging, it shares many similarities with other inflammatory arthritides and rheumatoid factor and uric acid should be checked to exclude rheumatoid arthritis and gout. 

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