Psoriasis is an autoimmune disease that usually affects only the skin, with the usual symptoms of psoriatic plaques affecting knees, elbows and BTE areas among others. Nails patient with psoriasis have a very typical Pitted concavities or grooves of this disease.
However, some patients develop also a joint (psoriatic arthritis) inflammation that can occur even before skin lesions, resulting in many patients visiting the orthopedist. Arthritis comes with pain, stiffness, swelling and increased local temperature articular. It can affect from the fingers, toes, and heels to the column.
Both cutaneous psoriasis and psoriatic arthritis are manifested outbreaks: the patient will not present phases disease (remission).
Psoriatic arthritis in hands
At the level of the hands, psoriatic arthritis inflames the proximal interphalangeal joints, giving an aspect of "sausage finger" and deforms the distal interphalangeal joints.
Diagnosis of psoriatic arthritis
The diagnosis is based on physical examination of the hands, feet and spine of the patient. Rheumatologist need to make a differential diagnosis with other diseases involving arthritis of the finger joints: rheumatoid arthritis, gout, pseudo-gout and arthritic degeneration.
Treatment of psoriatic arthritis in hands
There is no curative treatment of psoriatic arthritis.
Treatments that are offered are aimed at controlling symptoms (pain and inflammation), improve hand function and prevent disease progression to joint degeneration since it can be very limiting.
The multidisciplinary work of Rheumatologists, family physicians, dermatologists, physiotherapists and Surgeons hand is essential. There are several treatment options for psoriatic arthritis, according to the degree of aggressiveness that has the disease.
- Rheumatology medication: can delay joint degeneration.
- Articular infiltrations: improve symptoms of pain and swelling and therefore mobility.
- Physical therapy: decrease pain, increase joint function and prevent toe deformities that can reduce the overall function of the hand.
Hand surgery with psoriatic arthritis
Surgery should be performed by a surgeon Specialist Hand Surgery. He is the one who can decide when and how to perform the technique indicated to improve hand function. Most gestures are indicated surgical prosthetic replacement of joints (especially of the proximal interphalangeal joints) or arthrodesis (mostly indicated in the distal interphalangeal joints).