Diagnosis and management of psoriatic arthritis

Psoriatic arthritis (PsA) is a chronic inflammatory joint disease with heterogeneous clinical presentation, an unpredictable course and a tendency to irreversible joint damage. Joint damage can occur early in the disease also when significant clinical signs of arthritis are absent. These observations and currently availabe effective treatments in controlling skin and joint disease underline the importance of early diagnosis of psoriatic arthritis. Use of specific questionnaires for screening at-risk patients, knowledge of new classification criteria and judicious use of new imaging techniques are key to early diagnosis. Besides traditional terapy with non-steroidal anti-inflammatory drugs and the more active disease-modifying anti-rheumatic drugs, the advent of biologics (anti-tumor necrosis factor- inhibitors) has considrerably enhanced treatment options. Collaboration between dermatologists, radiologists and rheumatologists offers a new opportunity to establish early diagnosis and effective therapy for psoriatic arthritis.