title: Differential diagnosis of acute dactylitis psoriatica.
abstract: A bulbous or "sausage-shaped" finger may represent a special type of psoriatic arthritis without any rheumatoid factor activity. Dactylitis psoriatica must be suspected in cases of arthralgias progressing along the phalanges of a finger associated with global soft tissue swelling. Acute dactylitis psoriatica is characterized by an intermittent course combined with psoriatic and partly extremely mild or masked skin and nail changes. X-rays findings are spicular protuberances at diaphyses in a "cloudy collar" image. Symptomatic treatment of dactylitis psoriatica consists of non-steroidal antirheumatic drugs or basic gold salt therapy. In the interval additional surgical treatment using arthro-plasties and arthrodeses is indicated in cases of joint destruction. Amputation of the affected finger is not to be considered as a mandatory causal therapy of dactylitis psoriatica.
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001168:Arthritis / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D004008:Diclofenac / Q000627:therapeutic use; D005260:Female; D005385:Fingers; D006801:Humans; D008875:Middle Aged; D010000:Osteitis / Q000175:diagnosis; D010304:Paronychia / Q000175:diagnosis; D026741:Physical Therapy Modalities; D011565:Psoriasis / Q000175:diagnosis* / Q000628:therapy
chemical_list: D000893:Anti-Inflammatory Agents; D004008:Diclofenac