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Reflective practice in health care and how to reflect effectively
Koshy K, Limb C et al. International Journal of Surgical Oncology. 2017 2:e20
Hackett S, Mahmood F, Coates L, Helliwell P. Prompt diagnosis key in improving outcomes in psoriatic arthritis. Practitioner October 2022;266(1862):17-21
Prompt diagnosis key in improving outcomes in psoriatic arthritis
25 Oct 2022
If left untreated psoriatic arthritis (PsA) can result in progressive, irreversible joint damage causing chronic pain and disability. It is a chronic, autoimmune inflammatory condition that can affect up to 30% of patients with psoriasis. PsA is a multisystem disease affecting other organs such as the eyes, gut and tendons. It is associated with multiple comorbidities such as diabetes mellitus, cardiovascular disease and metabolic syndrome. If PsA is suspected in primary care, routine blood tests should be requested to check for anaemia of chronic disease and raised inflammatory markers. Plain radiographs of hands and feet should be requested prior to referral, although classical changes do not occur early in the disease. If GPs suspect PsA, prompt referral is paramount. Patients should be referred if they have persistent joint symptoms, a positive screening questionnaire (PEST), joint swelling, dactylitis or enthesitis, and/or inflammatory back pain.
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