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The importance of radiologic evaluation and physical examination in diagnosis of psoriatic arthritis and its prevalance in the Hospital Universitário Evangélico de Curitiba

BACKGROUND: Psoriatic arthritis (PA) is an inflammatory disorder associated with skin and nail disease, negative rheumatoid factor (RF) and absence of rheumatoid nodules. It can be a devastating and incapacitating condition. Its prevalence is highly variable, ranging from 2,6 to 7%; however, recent data shows prevalence as high as 23 to 69%. Its diagnosis is one of exclusion, and when detected early in the course of the disease gives chance to adequate treatment, thus avoiding its sequelae. The diagnosis is made by physical examination, laboratory and radiological evaluation. A normal radiological finding does not exclude the disease. OBJECTIVE: This study aims to evaluate the importance of a detailed physical examination associated with radiological findings in the diagnosis of PA and its prevalence in our institution. METHODS: Thirty patients with skin psoriasis were submitted to a thorough physical examination and radiological evaluation. All patients were inquired about articular complaints, time and severity of skin and nail disease. Those that presented any articular symptom were submitted to a laboratory evaluation with: Complete Blood Count (CBC), RF, Erythrocyte Sedimentation Rate (ESR) and radiography of the involved joint. RESULTS: The majority of patients (56,5%) presented arthralgia; however, only three patients had arthritis. Of those 3 that had PA, one presented a normal radiography but with an altered physical examination. CONCLUSION: The physical examination is an extremely important tool in the evaluation of patients with psoriasis. The radiological evaluation is not as important as the physical examination. The prevalence of PA was 10%.

Arthritis; Arthritis; psoriatic; Psoriasis


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