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银屑病关节炎与骨关节炎和类风湿关节炎的鉴别:高级执业医师的叙述性综述与指南

Differentiating Psoriatic Arthritis from Osteoarthritis and Rheumatoid Arthritis: A Narrative Review and Guide for Advanced Practice Providers.

作者信息

Saalfeld William, Mixon Amanda M, Zelie Jonna, Lydon Eileen J

机构信息

Arthritis Center of Nebraska, 3901 Pine Lake Road, Suite 120, Lincoln, NE, 68516, USA.

Arthritis and Rheumatology Clinic of Northern Colorado, Fort Collins, CO, USA.

出版信息

Rheumatol Ther. 2021 Dec;8(4):1493-1517. doi: 10.1007/s40744-021-00365-1. Epub 2021 Sep 14.

Abstract

Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects multiple organ systems and is characterized by skin and joint manifestations. PsA is frequently undiagnosed and/or misdiagnosed, especially because of the similarities in clinical presentation shared with other arthritic diseases, including rheumatoid arthritis (RA) and osteoarthritis (OA). An accurate and timely diagnosis of PsA is crucial to prevent delays in optimal treatment, which can lead to irreversible joint damage and increased functional disability. Patients are usually seen by a number of different healthcare providers on their path to a diagnosis of PsA, including advanced practice providers (APPs). This review provides a comprehensive overview of the characteristic features that can be used to facilitate the differentiation of PsA from RA and OA. Detailed information on clinical manifestations, biomarkers, radiologic features, and therapeutic recommendations for PsA included here can be applied in routine clinical settings to provide APPs with the confidence and knowledge to recognize and refer patients more accurately to rheumatologists for management of patients with PsA.

摘要

银屑病关节炎(PsA)是一种影响多个器官系统的慢性炎症性疾病,其特征为皮肤和关节表现。PsA常常未被诊断和/或误诊,特别是因为它与其他关节炎疾病(包括类风湿关节炎(RA)和骨关节炎(OA))有相似的临床表现。准确及时地诊断PsA对于防止最佳治疗的延误至关重要,否则可能导致不可逆转的关节损伤和功能残疾增加。在确诊PsA的过程中,患者通常会就诊于许多不同的医疗服务提供者,包括高级执业提供者(APPs)。本综述全面概述了可用于促进PsA与RA和OA鉴别的特征。这里包含的关于PsA的临床表现、生物标志物、放射学特征和治疗建议的详细信息可应用于常规临床环境,以使APPs有信心和知识更准确地识别患者并将其转诊给风湿病学家,以便对PsA患者进行管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7be8/8572231/4bef22c87ae0/40744_2021_365_Fig1_HTML.jpg

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