Psoriatic arthritis

Case contributed by Alexandra Stanislavsky
Diagnosis almost certain

Presentation

Swelling of the fingers and toes.

Patient Data

Age: 50 years
Gender: Male
x-ray

There are erosive changes involving the distal interphalangeal joints of both the hands and the feet, with irregular "fuzzy" joint margins and evidence of bony overgrowth at the margins. 

The changes involve predominantly both 2nd DIP joints of the hands, and both 1st interphalangeal joints of the toes (i.e. a symmetric oligoarthropathy in this case). The PIP and MCP joints are spared.

Case Discussion

Typical radiographic features of psoriatic arthropathy.

The patient had a longstanding history of psoriasis.

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