Orthopedic Manifestations and Management of Psoriatic Arthritis
Eric J. Strauss, MD, Daniel Alfonso, MD, Gurpinder Baidwan, MD, and Paul E. Di Cesare, MD
Dr. Strauss is an Orthopaedic Surgery Resident, Dr. Alfonso is an Orthopaedic Surgery Resident, and Dr. Baidwan is a Research Assistant, Musculoskeletal Research Center, Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York.
Dr. Di Cesare is Professor and Chair, Department of Orthopaedics, University of California at Davis School of Medicine, Sacramento, California.
Psoriatic arthritis is a complex, chronic inflammatory disease with both skin and joint involvement. Clinical presentation varies considerably among patients and during the course of the disease. Assessment of patients for psoriatic arthritis requires careful attention to patient history, a focused physical examination, and inspection for characteristic radiographic changes. Although this disease was once thought to be a rare and mild form of arthritis, recent studies have shown that patients with psoriatic arthritis may develop significant disability, with up to 20% of cases demonstrating a rapidly progressive, debilitating clinical course. Orthopedic manifestations of the disease can be severe and can cause significant physical disability. Although surgical intervention for psoriatic arthritis is relatively uncommon, having an understanding of the assessment, available treatment options, and surgical considerations allows for improved outcome in the management of this complex patient population.