The key clinical features are:
History
- Joint pain, stiffness and swelling affecting the PIP and DIP joints of the hands, feet and large joints (figure 1).Symmetrical/asymmetrical.
- Early morning stiffness (typically >30 minutes)
- Inactivity gelling (stiffness after a period of inactivity)
- History of psoriasis/family history of psoriasis
- May have inflammatory back pain symptoms
- May have IBD/uveitis/iritis
Examination
- Joint swelling and tenderness
- Nail changes e.g., pitting
- Psoriasis
Investigations
- FBC ,UE,LFT,CRP/ESR (may be normal)
- Anti-CCP antibodies (typically negative)
- X-ray of hands or feet (erosions)
M.A & S.R/H.B. 25-01-24
