Psoriatic arthritis in the hand

Psoriatic arthritis is a polyarthropathy distinct from rheumatoid arthritis and associated with onychodystrophy and skin lesions. Patients present with stiffness, flexion and extension contractures, digital swelling, or painful joints. Psoriatic arthritis mutilans is a rapidly progressive osteolysis resulting in severe deformity. Radiographs reveal widened joint spaces with interphalangeal joint destruction, resorption of the distal tufts, and frequently spontaneous fusion. Surgery involves mainly salvage procedures to relieve pain or improve position, as the increase in motion obtained usually is limited.