a Rheumatology Department of Lucania , San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera , Potenza , Italy.
Expert Rev Clin Immunol. 2016 Nov;12(11):1209-1215. doi: 10.1080/1744666X.2016.1193436. Epub 2016 Jun 10.
Psoriatic arthritis (PsA) is a heterogeneous chronic inflammatory disease characterized by a wide clinical spectrum. The early diagnosis of PsA is currently a challenging topic. Areas covered: The literature was extensively reviewed for studies addressing the topic area "diagnosis of psoriatic arthritis". This review will summarize improvements in diagnostic tools, especially referral to the rheumatologist, the role of patient history and clinical examination, laboratory tests, and imaging techniques in getting an early and correct diagnosis of PsA. Expert commentary: Due to the heterogeneity of its expression, PsA may be easily either overdiagnosed or underdiagnosed. A diagnosis of PsA should be taken into account every time a patient with psoriasis or a family history of psoriasis shows peripheral arthritis, especially if oligoarticular or involving the distal interphalangeal joints, enthesitis or dactylitis. Magnetic resonance imaging and ultrasonography are useful for diagnosing PsA early, particularly when isolated enthesitis or inflammatory spinal pain occur.
银屑病关节炎（PsA）是一种表现多样的慢性炎症性疾病，具有广泛的临床谱。目前，PsA 的早期诊断仍是一个具有挑战性的课题。
本文广泛综述了探讨“银屑病关节炎的诊断”这一主题领域的文献。本综述将总结诊断工具的改进，特别是向风湿病医生的转诊、患者病史和临床检查、实验室检查以及影像学技术在早期正确诊断 PsA 中的作用。
由于其表现的异质性，PsA 可能很容易被过度诊断或漏诊。当银屑病患者或有银屑病家族史的患者出现外周关节炎时，尤其是当关节炎为少关节炎或累及远侧指间关节、附着点炎或指（趾）炎时，应考虑 PsA 的诊断。磁共振成像和超声检查有助于早期诊断 PsA，特别是当出现孤立的附着点炎或炎症性脊柱痛时。
