Psoriatic arthritis (PsA) is a chronic heterogeneous inflammatory musculoskeletal disease. The non-specific and often subtle manifestations make early diagnosis and subsequent treatment challenging. In the absence of diagnostic criteria and biomarkers, the diagnosis is often delayed leading to poor long-term outcomes. In addition, the differential diagnosis of a patient presenting with arthritis in the setting of skin psoriasis is wide due to symptom overlap with many other diseases. Peripheral arthritis, dactylitis, enthesitis and axial arthritis are the 4 domains of musculoskeletal involvement in PsA and careful examination of each domain by a rheumatologist is the first step for a correct diagnosis. Other extra-musculoskeletal features such as the presence of uveitis, inflammatory bowel disease, nail psoriasis and elevated acute phase reactants aid in the diagnosis of PsA. Screening patients with skin psoriasis using validated questionnaires might help in early diagnosis especially when coupled with imaging.

中文翻译：

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银屑病关节炎的临床诊断面临挑战。

银屑病关节炎（PsA）是一种慢性异质性炎性骨骼肌疾病。非特异性且通常微妙的表现使早期诊断和后续治疗具有挑战性。在缺乏诊断标准和生物标志物的情况下，诊断通常会延迟，导致不良的长期结果。另外，由于症状与许多其他疾病重叠，因此在皮肤牛皮癣情况下患有关节炎的患者的鉴别诊断是广泛的。周围性关节炎，齿根炎，皮炎和轴性关节炎是PsA中肌肉骨骼受累的4个领域，风湿病学家仔细检查每个领域是正确诊断的第一步。其他肌肉骨骼外功能，例如葡萄膜炎，肠炎，指甲牛皮癣和急性期反应物升高有助于诊断PsA。使用经过验证的问卷对皮肤牛皮癣患者进行筛查可能有助于早期诊断，尤其是与影像学结合时。