RESEARCH - The role of trauma in psoriatic arthritis

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Journal of Rheumatology

Editorial

Nov 2008

Role of Trauma in Psoriatic Arthritis

IGNAZIO OLIVIERI, MD,

Consultant, Director;

ANGELA PADULA, MD,

Senior Registrar;

SALVATORE D'ANGELO, MD,

Researcher,

Rheumatology Department of Lucania,

San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of

Matera, Potenza;

RAFFAELE SCARPA, MD,

Associate Professor of Rheumatology,

Rheumatology Research Unit,

University Federico II, Naples, Italy

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Trauma has long been thought to play a triggering role in various

types of inflammatory arthritis including rheumatoid arthritis (RA),

gout, chondrocalcinosis, and the spondyloarthritides (SpA), especially

psoriatic arthritis (PsA).

The first article on trauma in PsA appeared in 19591. Buckley and

Raleigh described the case of a patient who developed acroosteolysis

without associated articular inflammation after trauma. The observed

bony lysis was explained as a result of a " deep Koebner's " effect. A

similar case was reported by and coworkers in 19712. The case

of a patient with psoriasis who developed a post-traumatic erosive

arthritis in his right hand was reported by and 3. In

1978, reported several psoriatic patients who had developed

arthritis after trauma4. These patients had been diagnosed as having a

mechanical derangement until arthrotomy revealed synovial

proliferation. The author suggested that patients with PsA have

susceptibility to trauma and that any traumatic arthritis in a patient

with psoriasis failing to settle in the usual way should be considered

to be monoarticular PsA until proved otherwise.

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