Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA.
J Am Acad Orthop Surg. 2012 Jan;20(1):28-37. doi: 10.5435/JAAOS-20-01-028.
Psoriatic arthritis is a chronic inflammatory arthropathy that affects approximately 6% to 48% of patients with psoriasis. Arthritis is not correlated with the extent of skin disease. Classic radiographic findings of the involved joint include erosion, ankylosis, and fluffy periostitis. Site-specific characteristic deformities such as pencil-in-cup deformity of the phalanges also may be present. The disease typically follows a moderate course, but up to 47% of cases develop into destructive arthritis in which the inflammatory process leads to bony erosion and loss of joint architecture. The mainstay of treatment is biologic therapy (eg, tumor necrosis factor-α inhibitors) in conjunction with disease-modifying antirheumatic drugs. Patients with end-stage joint destruction may require surgery to alleviate pain and restore function. Orthopaedic surgeons should be cognizant of the risk factors (eg, increased risk of cardiovascular disease) and potential complications (eg, poor wound healing and increased risk of infection) associated with psoriatic arthritis.
银屑病关节炎是一种慢性炎症性关节病，影响约 6%至 48%的银屑病患者。关节炎与皮肤病的严重程度无关。受累关节的典型放射学表现包括侵蚀、强直和绒毛状骨膜炎。也可能存在特定部位的特征性畸形，如指骨的铅笔尖样畸形。该病通常呈中度病程，但多达 47%的病例发展为破坏性关节炎，炎症过程导致骨侵蚀和关节结构丧失。治疗的主要方法是生物疗法（如肿瘤坏死因子-α抑制剂）联合改善病情的抗风湿药物。终末期关节破坏的患者可能需要手术来缓解疼痛和恢复功能。矫形外科医生应认识到与银屑病关节炎相关的风险因素（如心血管疾病风险增加）和潜在并发症（如愈合不良和感染风险增加）。
